Medicine and Health Sciences Commons^™

Justification And Compliance: Public Health Ethics In A Post-Covid America, Nathan Alan Turner

Undergraduate Honors Theses

The severity of the COVID-19 pandemic and the high-profile nature of the public health response make it a natural context for exploring the current state of public health ethics. This paper explores this topic from two perspectives: justification and compliance. Libertarianism and utilitarianism are two frameworks that dominate the question of how public health interventions are justified. Consequently, this paper analyzes the events of the pandemic to determine how these frameworks fared in terms of offering reliable means of justifying the interventions needed to curb the spread of COVID-19. Consideration of these events suggests that a framework centered around actionable …

Cyclic-Di-Gmp-Binding Proteins Regulate Acinetobacter Baumannii Motility, Gabriel Smith

Undergraduate Honors Theses

Acinetobacter baumannii is a prevalent nosocomial pathogen where, like many other infectious bacteria, A. baumannii is increasingly considered a multi-drug resistant pathogen. This research study was designed to find a way to affect the persistence of A. baumannii such that it can be applied to a hospital setting to prevent further nosocomial infections. One regulatory mechanism potentially used by A. baumannii to persist on hospital surfaces is through the use of the bacterial second messenger cyclic-di-GMP (c-di-GMP). This nucleotide signal is regulated in response to environmental conditions, and then activates c-di-GMP-binding proteins that induce phenotypic changes. One c-di-GMP-regulated phenotype is …

Evaluating The Effectiveness Of Restorative Justice Rehabilitative Services Available In Northeast Tennessee For Mothers Diagnosed With Substance Use Disorder, Claire Roberson

Undergraduate Honors Theses

Substance Use Disorder (SUD) has plagued families of rural Appalachia for many years, perpetuating involvement in the criminal justice system as well as generational trauma for people diagnosed with SUD and their children. This points to the necessity of a trauma-informed, restorative-justice based framework for rehabilitative services to most effectively heal families, address trauma, and re-integrate people diagnosed with SUD into society. A restorative justice-based program would provide health care services for addiction and any comorbid mental health disorders as well as teach parents how to properly provide for themselves and their families, manage finances, obtain employment, and further education. …

The Distribution Of Opioid Settlement Funds In Northeast Tennessee, Amani Patel

Undergraduate Honors Theses

Opioid Use Disorder is defined by the NIH as “the chronic use of opioids that causes

clinically significant distress or impairment.”1 Due to a number of factors, the overuse of opioids has become an epidemic in the United States. In recent years there have been a number of lawsuits against pharmaceutical companies and other parties who have benefitted from the proliferation of this issue. In most cases, it is up to the states or local governments who receive these funds to determine their best use. The purpose of this Thesis is to analyze the resources recommended by Ballad Health’s Community …

Covid-19 In Tennessee: Lessons Learned And A Tool For The Future, Allen Archer, Randy Wykoff, Megan Quinn

Undergraduate Honors Theses

Background: In late 2019, the SARS-CoV-2 virus was identified in Wuhan, China. Within a matter of weeks, the virus spread to the United States and many other countries around the world. By March 5, 2020, the first case of COVID-19 (the disease caused by the SARS-CoV-2 virus) was identified in the state of Tennessee, and the first known COVID-19 associated death in the state followed on March 20, 2020. In 2020 alone, there were 514,922 confirmed cases and 6,760 COVID-19 attributed deaths in the state of Tennessee. It is important to understand, however, that confirmed COVID-19 deaths do not accurately …

The Effects Of The Transition From Pre-Nursing To Nursing On Mental Health, Andrew J. Davis, Paige R. Mullins, Kimberly A. Sell

Undergraduate Honors Theses

Mental health is an ever-growing crisis among adolescents and young adults, with suicide as second leading cause of death and the number of those negatively affected continually on the rise. Transitions are one of the major stressors prevalent among these age groups, placing individuals at risk for mental health deficits. This quantitative voluntary response comparative study assesses the transitional mental health of pre-nursing students and students in the nursing program at East Tennessee State University. Emailed to all with a declared major of pre-nursing or nursing, this study measured mental health using evidenced based assessment tools. The PHQ-9 for depression …

Comparison Of Short Chain Volatile Fatty Acids In The Breastmilk Of Normal And Overweight/Obese Mothers, Ellen Gaskill, W Andrew Clark, Kristy L. Thomas, Amy Wahlquist, Michelle E. Johnson

Undergraduate Honors Theses

INTRODUCTION: Health professionals emphasize the importance of breastfeeding in the development of children up to 6-months of age. It is known that short chain volatile fatty acids (SCVFAs) are a byproduct of nutrient fermentation by gut microbiome. These SCVFAs interact with the gut/brain axis and are known to influence infant development. Therefore, a reflection of maternal gut microbiome could likely be found in breastmilk (BM) due to diffusion of SCVFAs across the gut wall into the blood. Previous research in our laboratory has shown differences in the SCVFA fecal fermentation profile between individuals with normal (N) versus overweight/obese (OWOB) body …

An Exploration Of Low-Income Dental Services In The Tri-Cities, Macie Proffitt

Undergraduate Honors Theses

Dental care has great importance in the overall health of every individual. Many do not realize the effect oral health plays in their overall health and many areas in the United States do not have access to the dental care needed to obtain proper healthcare standards. In many of these areas, such as the Appalachian region, dental services for low-income citizens are limited. Specifically, in the Northeast Tennessee region, these dental services are severely limited. Washington County and Hawkins County of Northeast Tennessee are specific underserved areas in the Appalachian region. The purpose of this project was to explore the …

Preserving Safety While Upholding The Integrity Of Medical Education And Practical Skills: The Impact Of Covid-19 On Teaching Human Anatomy, Anna Cowan

Undergraduate Honors Theses

The global pandemic caused by COVID-19 placed constraints on several aspects of normal life, especially those of higher level education. While many programs moved to teaching in a strictly online format, there are some courses in which this structure was not appropriate. This study observed the outcome of the adapted course structure employed at Quillen College of Medicine during their Gross Human Anatomy course. Through a voluntary survey and multiple independent t-tests, it was demonstrated that the students who took the adapted course performed, on average, 2 points lower on each exam than previous classes. Also, this study showed that …

A Comparative Study Of Recovery Ecosystems For Opioid Use Disorder In Portugal And Appalachia, Jonathan David Mullins

Undergraduate Honors Theses

A comparison of the structure and effectiveness of recovery ecosystems for opioid use disorder in Portugal and Appalachia, with a focus on identifying areas for improvement within the Appalachian region.

Dna Transfer In The Soil Bacterium Rhodococcus, Jaimin Maheshbhai Kapadia

Undergraduate Honors Theses

Gene transfer plays an important role in bacterial evolution. Especially in an under explored species like Rhodococcus, a type of bacteria found in the soil. Rhodococcus has several applications in the pharmaceutical industry and in the production of antibiotics. Rhodococcus possess several unique sets of properties which makes it beneficial to have a reliable method of producing mutants of Rhodococcus. The goal of the experiment was to find an efficient way of forming Rhodococcus colonies with kanamycin resistant genes. The project began from an unexpected observation from an earlier experiment with Rhodococcus strain MTM3W5.2. where I attempted to transform this …

Comparing Heatwave Related Mortality Data From Distressed Counties To Affluent Counties In Central And Southern Central Appalachia, Miranda Taylor Pardue

Undergraduate Honors Theses

The Appalachian Mountains are home to some of the most culturally rich places in the United States, but also some of the most impoverished communities as well. Several recent events support climate change across the globe. It is expected that Appalachian communities may suffer more dire consequences, as many communities lack strategies to help relieve some of the worst effects of climate change. Heatwaves are predicted to increase in duration and frequency over time, and communities that are not well prepared for the damaging effects of heatwaves can suffer unduly. This study aims to quantify the likelihood that people living …

Examination Of The Polymicrobial Interaction: Inhibitory Effects Of Alcaligenes Species On Members Of The Candida Species, Madelyn Whitlock

Undergraduate Honors Theses

Candida species are commonly found in the human normal flora, however they are a major cause of nosocomial infections that can be life threatening. This fungal species is an opportunistic pathogen and causes infection in individuals who are immunosuppressed. A key characteristic of Candida’svirulence is the ability to change its morphology from ovoid yeast to filamentous hyphae. Alcaligenes species are common bacteria found in the environment that rarely, if at all, cause infections in humans. It has been observed that when allowed to interact, Alcaligenes faecalis changes the morphology of Candida albicans from yeast cells to hyphal cells. When …

Polysubstance Exposure And Its Relationship To Pharmacological Treatment Characteristics, Parker Miller

Undergraduate Honors Theses

Neonatal Abstinence Syndrome (NAS) remains an ever-growing public health issue and a continued avenue for future research. The research question for this retrospective study was whether polysubstance exposure is related to the dose of medication the infant received or to the number of opioid-medications required to treat the infants’ withdrawal symptoms? The hypothesis for the retrospective study was there will be a significant relationship between polysubstance exposure and the dose of medication the infant received as well as the number of opioid-medications required to treat the infants’ withdrawal symptoms. A bivariate correlational indicated that there was not a significant association …

Determining How Temperature Affects The Survival Of Salmonella And E. Coli Species In Sinking Creek: A Meta-Evaluation, Miranda Liner

Undergraduate Honors Theses

In recreational waters, pathogen pollution is a major concern for the USEPA. The USEPA is responsible for initiating the National 303(d) List of Impaired Surface Waters. Pathogen pollution from E. coli is a common reason why recreational waters are placed on the 303(d) list. E. coli O157 H:7 and other enteric pathogens can cause serious illness and even death. Sinking Creek is a part of the Watauga River watershed which runs through Carter and Washington county. Sinking Creek is currently listed on the 303(d) as impaired due to the presence of E. coli. Because of the known presence of …

Social Support For Physical Activity For High Schoolers In Rural Appalachia, Pooja M. Shah

Undergraduate Honors Theses

The purpose of the present study is to conduct a secondary qualitative analysis to examine parent, teacher, and high school adolescents’ perceptions of social support for physical activity (PA) for high schoolers in Southern Appalachia. Social support for PA is linked to higher rates of PA participation in adolescents. Parents, siblings, and peers provide key sources of support. Social support for PA may be even more important in under-resourced communities such as Appalachia, where geographic, economic, and environmental barriers negatively impact PA engagement. During 2013-2014, focus groups and semi-structured interviews were conducted with parents of adolescents (n=39), high school teachers …

Burn Wound Bacteria Susceptibility To A Novel Antimicrobial Compound, Bo H. Marshall

Undergraduate Honors Theses

A breach of the skin barrier, due to a burn wound, facilitates colonization by various microorganisms. Burn wounds can become colonized from the patients’ own skin flora, respiratory tract, or with exogenous bacteria from the environment. Strategies to treat burn wound infections are multipronged: removal of the infected necrotic tissue, wound dressing to protect the damaged area, and treatment with specific antimicrobials to prevent reinfection. The development of chronic infections, which could potentially lead to sepsis, depends largely on how well the microorganisms form biofilms within the wound. There are numerous antimicrobial gels and antibiotics that help prevent a burn …

Salmonella And Aeromonas Contamination In A 303(D) Listed Water Body Compared To Fecal Indicators & Water Quality Parameters, Elizabeth M. Morgan Ms.

Undergraduate Honors Theses

Since the passage of the Clean Water Act, concern about surface water quality has increased. Reducing exposure to pathogens and adverse impacts on human health because of contact with surface waters has become the focus of many regulatory agencies. Fecal pollution is often a cause of surface water impairment. Fecal indicators, such as fecal coliforms and Escherichia coli, are used as surrogates to evaluate the presence or absence of fecal pollution. However, a growing body of research has shown that these species lack key characteristics necessary to be adequate indicators. As such, explorations into the efficacy of indicator species …

Long-Term Sustainment Of Rapid Improvement Events: A Case Study In “Room Readiness”, Gabriela V. Coronel

Undergraduate Honors Theses

Shifting payment models from fee for service (FFS) to pay for performance (P4P) have fundamentally changed the environment of healthcare administration in the United States (Center for Medicaid and Medicare Services (CMS), 2011). Due to this shift, there has been an increase in demand for tracking and improving quality measures to ensure not only patient safety, but optimization of utilization. Constraints on resources and capacity, coupled with increasing safety measures has developed a new study of patient flow (Miró, Sánchez, Espinosa, et al., 2003). Decreasing patient room turnover times has the potential to maximize utilization while ensuring patient safety and …

Do Stress Levels Differ Between First Semester Nursing Student Early In The Semester Vs. The End Of The Semester?, Alissy Heisey

Undergraduate Honors Theses

This study intends to determine how stress levels change over time in nursing students in the Baccalaureate program at East Tennessee State University. The instrument utilized for this survey was the Perceived Stress Scale by Mind Garden, Inc. This survey was passed at the beginning of the semester and at the end of the semester. There was no-significant difference found between the two time spots, leading us to conclude that the level of stress perceived by nursing students is a steady factor during their school semester.

Perceived Barriers To Obtaining Psychiatric Treatment At Johnson City Community Health Center, Mychal Bolton

Undergraduate Honors Theses

The purpose of this study was to describe the perceived barriers to obtaining psychiatric treatment at the Johnson City Community Health Center. The context of the study was a rural area in Eastern Tennessee. Five patients with confirmed DSM-IV mental health diagnoses were recruited during treatment and interviewed at the Johnson City Community Health Center after their scheduled appointments with a Mental Health Nurse Practitioner (MHNP). The semi-structured interview focused on perceived barriers to obtaining treatment, perceptions of treatment received, and perceived availability of treatment. From those interviews, two themes were identified and each of which had two sub-themes identified: …

The Johnson City Community Health Center: A Qualitative Analysis Of The Center's Strengths, Weaknesses, Opportunities, And Threats In Johnson City, Tennessee, Enrique A. Cruz Enriquez

Undergraduate Honors Theses

The Johnson City Community Health Center is one of over 1200 community health centers serving over 22 million patients across the United States. Community health centers primarily serve patients with low income or without health insurance, but most serve all the members of their communities. These centers provide many services and treat health problems in a holistic manner in order to improve the health of their communities and also allow the members of those communities to progress. The Johnson City Community Health Center is compared to successful CHCs from across the nation to determine if it has characteristics to be …

"Nursing Contamination: Wearing Scrubs In Public", Kemble Green

Undergraduate Honors Theses

Nurses are frequently seen in public in their “scrubs,” which could mean that contaminated clothing is being brought into the community, thereby posing an infection risk. The purpose of this study is to investigate if and which contaminants are present on the fabrics and the actions nurses are taking to eliminate contamination risks.

Eleven scrub tops were worn on hospital units over one twelve-hour shift. The contaminated scrubs and three control tops were then swabbed and used to inoculate agar plates. After incubation, colonies were counted, streaked onto nutrient and Mannitol-salt agar for isolation, and incubated. Using API Staph strips …

The Prevalence Of Smoking In Nursing Students, Jennifer Trotter

Undergraduate Honors Theses

Tobacco use is one of the most preventable sources of death and disease, and yet remains a worldwide problem. With the rising costs of healthcare, the focus of efforts to control them has honed in on lifestyle behaviors that contribute to the escalating costs. Within the scope of this scrutiny, the prevention or cessation of smoking and tobacco usage has become a global priority and a major focal point of worldwide anti-tobacco initiatives. The World Health Organization (WHO) has identified cessation interventions by health care professionals as a crucial factor in successful patient smoking cessation, and studies have shown that …