Medicine and Health Sciences Commons^™

Prescription Drug Abuse And Provider-Patient Communication: A Qualitative Analysis Of The Perspectives Of Prescribers And Patients, Stephanie M. Mathis

Electronic Theses and Dissertations

Prescription drug abuse is a public health problem of epidemic proportions in the United States. Provider-patient communication underpins many initiatives aimed at preventing and reducing the public health burden of prescription drug abuse. The characteristics of and factors contributing to this interpersonal process, however, have not been fully explored.

The purpose of this research was to examine: 1) the overall problem of prescription drug abuse and provider-patient communication about prescription drug abuse from the patient perspective; and 2) provider-patient communication about prescription drug abuse from the prescriber perspective. In 2014-2015, semi-structured interviews were conducted with 20 patients from primary care …

Access To Healthy Foods: A Descriptive Analysis Of Farmers’ Markets, Food Deserts & Usda Food Assistance Programs In Tennessee Census Tracts, Twanda D. Wadlington

Electronic Theses and Dissertations

Food deserts are a growing problem in the United States, and occur in areas of low-income where people have limited access to healthy foods. In response, the presence of farmers’ markets has grown exponentially, and improved healthy food access. Additionally, the USDA has strived to connect families to healthy foods through food assistance programs such as the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and the Senior Farmers’ Market Nutrition Program (SFMNP). This study investigated the relationship between farmers’ markets, their acceptance of food assistance benefits, and their locations within Tennessee …

The Effects Of A Supermarket Tour On Improvement Of Nutrition Knowledge And Eating Behavior, Elizabeth Hall

Electronic Theses and Dissertations

The purpose of this study was to determine if participation in a supermarket tour improves nutrition knowledge and eating behavior in adult participants. Participants were recruited in communities surrounding Food City stores, a local supermarket. Prior to completing a standardized tour, participants completed a survey to assess nutrition knowledge and eating behavior. This survey was given to participants again three months later. A program evaluation was given one time at the end of the tour. Data analysis revealed no significant findings, other than the behavior-based question: “How many meals or snacks on most days included vegetables”. Vegetable consumption appeared to …

Social-Ecological Factors Affecting Patient Shield Use Among Radiologic And Computed Tomography Technologists, Megan Housenick-Lee

Electronic Theses and Dissertations

Medical radiation is estimated to contribute to over 200,000 deaths annually. Recent increases in the use of radiation-producing medical imaging examinations have led to increasing cumulative radiation dose to the general public. Multiple measures have been taken to address this alarming trend, including physician education, technologist education on dose reduction, and equipment-facilitated dose reduction techniques. Shield use can reduce the primary beam by up to 95%. Medical imaging technologists are the primary individuals responsible for applying shielding during an examination. Currently, literature shows that technologists are not shielding individuals as often as they should.

After pilot testing, medical imaging technologists …

Merging Cultures: Organizational Behavior, Leadership, And Differentiation In A Health System Merger, Colin G. Chesley

Electronic Theses and Dissertations

Health system mergers and acquisitions (M&As) have increased exponentially in recent years as a result of the Affordable Care Act (Brown, Werling, Walker, Burgdorfer & Shields, 2012). M&As are consummated as a way to control for interdependencies within the market, control costs and leverage debt, and negotiate better rates among health insurers (Bolman & Deal, 2013; Cooper & Finkelstein, 2010; Mirc, 2013). Regardless of the impetus for a merger, the largest predictor of the success or failure of a M&A lies within the organizational culture (Brown, et al., 2012; Cooper & Finkelstein, 2010; Kastor, 2010; Ovseiko, Melham, Fowler & Buchan, …

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 …

An Epidemiological Study Of Obesity Among Asian Americans In California, United States, Shaoqing Gong

Electronic Theses and Dissertations

Obesity has reached epidemic levels in the United States (U.S.). Despite an increasing number of studies on obesity, a very few have addressed this debilitating condition among Asian American adults. The overall objective of this study is to utilize the latest cycles of the California Health Interview Survey (CHIS) to better understand obesity and identify its correlates among Asian Americans. The study population comprised Asian American adults aged 18 years or older from the CHIS with data pooled from the 2013 and 2014 survey years. Obesity (≥27.5 kg/m²) was defined using the World Health Organization (WHO) Asian body …

Correlates Of Human Papillomavirus (Hpv) Vaccine Acceptance In Appalachian Tennessee, Oluwatosin Ariyo

Electronic Theses and Dissertations

Human papillomavirus (HPV) is the most prevalent sexually transmitted infection in the U.S., where one HPV-related cancer is diagnosed every 20 minutes. The most common HPV-related cancer is cervical cancer, with an estimated incidence of 12,000 cases annually, a third of which lead to death. Cervical cancer disparately affects women of ethnic minority groups and geographically isolated regions, such as Appalachia. Tennessee ranks third highest in cervical cancer incidence in the country. Many cases of cervical cancer could be prevented through vaccination against HPV, however, vaccination rates for females in Tennessee are among the lowest in the country. This mixed-methods …

An Investigation Of The Relationship Between Child, Family, And Community Factors And Early Childhood Oral Health And The Utilization Of Dental Health Services, Nicole Holt

Electronic Theses and Dissertations

Background / Objective: Children under the age of 5 years bear a disproportionate burden of oral disease. The aim of this study is to investigate how child, family, and community determinants impact dental care utilization, and parental report of child’s oral health. Methods: Data for this study came from the 2011/2012 National Survey of Children’s Health for children aged 1 to 5 years old. Dependent variables evaluated were if the child had an oral health problem, been to a dentist in the past year, and parents description of the child’s teeth. Independent variables were selected from child, family, and community …

Phenomenological Study Of The Lived Experiences Of Appalachian Spouses Of Combat Veterans With Post Traumatic Stress Disorder, Janice E. Greene

Electronic Theses and Dissertations

This study was conducted to identify gaps in existing knowledge regarding impacts of combat-related PTSD on the spouse and to gain an understanding of the lived experience of Appalachian Spouses of combat veterans with PTSD. A systematic literature review was conducted to identify research and findings on the impacts of combat-related PTSD on spouses of veterans and a qualitative study was conducted to gain an understanding of the lives of Appalachian spouses of combat veterans with PTSD.

The systematic review identified 16 qualitative studies conducted between 1988 and 2016 in five countries spanning five wars. Regardless of the country 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 …

Assessment Of Social, Dietary And Biochemical Correlates Of Cardiometabolic Risk In Pre-Adolescent Hispanic Children, Abraham Basil Alhassan

Electronic Theses and Dissertations

Obesity, elevated blood pressure and dyslipidemia are highly prevalent in Hispanic children. Compared to their non-Hispanic White peers, Hispanic children experience higher prevalence of obesity and hypertension. The Hispanic population in Tennessee has been growing, with about a tenth of newborn babies being Hispanic. This study aimed to: 1. Examine the influence of sociodemographic factors on Hispanic children’s cardiometabolic risk; 2. Assess the relationship between food group intake and cardiometabolic risk in Hispanic children; and 3. Evaluate the efficacy of non-traditional biomarkers for detecting cardiometabolic risk in Hispanic children. Data for the study came from a larger cross-sectional pilot study …

The Increasing Risk Of Vector-Borne Diseases: Mapping The Effects Of Climate Change And Human Population Density On Future Aedes Aegypti Habitats, Julie Obenauer

Electronic Theses and Dissertations

The Aedes aegypti mosquito is the vector for four infectious diseases of global concern – Yellow Fever, Dengue, Chikungunya, and Zikavirus. Previous attempts to model the expansion of the vector habitat due to global climate change have rarely included characteristics related to the human populations on which this mosquito is dependent. The purpose of this research was to determine whether the inclusion of human population density improves model performance while creating risk maps that can be used to determine where humans are most likely to be exposed to the vector in the future. The resulting model demonstrated that the inclusion …