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Beyond Fentanyl Test Strips: The Need To Decriminalize All Drug Checking Equipment In Tennessee, Jeremy C. Kourvelas Mph

SMART Policy Briefs

KEY POINTS

• In 2022, Tennessee decriminalized fentanyl test strips (FTS) through Public Chapter 764. Thousands have since been distributed by the state and nonprofit coalitions as a key harm reduction strategy. As of the end of 2023, 44 other states and D.C. had also decriminalized FTS.

• Research indicates that people who use drugs are five times as likely to change their behaviors (including reducing drug use overall) in response to a test result that is positive for fentanyl. People who use methamphetamine are especially likely to change their behaviors.

• However, the law only applies to “narcotic testing equipment used to …

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The Causes And Implications Of Burnout Among Graduate Assistants, Katherine Mary Kuka

Masters Theses

Introduction & Background

Acting as both a student and staff member of a university, the unique role of graduate assistants can often become a catalyst of burnout and stress. Recent studies found 60% of graduate assistants met the criteria for burnout (Park et al., 2021) and 43% of graduate students claim to be experiencing more stress than they can handle (Allen et al., 2021). In this case, burnout is defined as, “A state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress” (Parker & Tavella, 2022). Graduate assistants are a subpopulation of graduate students that is growing …

41 For Freedom: Ballistic Missile Submariners And The Nuclear Deterrent Shield During The Cold War, Jeremy Daniel Long

Masters Theses

Ballistic missile “boomer” submarines were developed in the 1960s as a response to the Soviet launch of the Sputnik satellite which proved the Soviet Union could launch a missile targeting anywhere on Earth. They made use of new nuclear power technology which allowed submarines to stay underwater indefinitely, limited only by the food they could carry to feed their crews. Ballistic missile submarines have served continuously since 1960, patrolling the ocean as the second-strike capability that makes nuclear deterrence possible. The men who served aboard the “41 for Freedom” ballistic missile submarines made innumerable sacrifices and contributed greatly to national …

Discriminative Nursing Care Practices Towards Patients With Opioid Use Disorder In The Hospital Setting: How Knowledge And Social Attitudes Impact Care Delivery, Jeanne Adam Bernier

Doctoral Dissertations

Discriminative nursing care (DNC) practices towards patients with opioid use disorder (OUD) is a current phenomenon negatively affecting patient care and patient outcomes. It leads to delays in care, insufficient pain control, and feelings of guilt and shame, and it is linked to self-isolation, social isolation, social rejection, and even unemployment and housing disruption which perpetuate a dangerous cycle of inequity that is hard to overcome. In some cases, OUD stigmatization even increases morbidity and mortality rates. OUD stigmatization and discrimination are real problems in today’s health care climate due to the vast number of people affected by OUD and …

Investigating The Transfer Of Learning, Psychological, And Neural Effects In Immersive Virtual Reality, Logan Taylor Markwell

Doctoral Dissertations

Achieving mastery or expertise requires a substantial amount of quality practice. Recent technological developments have introduced a novel approach to practice, virtual reality. Specifically, virtual reality offers a low-cost, customizable opportunity to practice while minimizing the risk of the individual. Given that some types of practice may not lead to the acquisition of a motor skill, or worse, lead to detriments of that skill, understanding the developing science of motor behavior in relation to virtual reality is imperative. The following literature review will begin with a brief historical account of the evolution of virtual reality. Next, some terms of virtual …

Serving American Veterans: A Review And Analysis Of Gaps In Service In The Needs Of Veterans, Mary Elisabeth Germann

Baker Scholar Projects

The United States Department of Veterans Affairs is the agency of the federal government that is responsible for providing benefits, health care, and cemetery services to US military Veterans and their families. About a quarter of the nation’s population, approximately 70 million people, are potentially eligible for VA benefits and services because they are veterans, family members, or survivors of veterans. Due to this expansive demand, the United States has developed the most comprehensive system of Veterans assistance programs in the World. But many argue that the US VA still falls short of expectations and fails to fulfill the needs …

Faith Influences On Health Of Rural Appalachian Older Adults In East Tennessee: An Ethnonursing Study, Karina Elizabeth Strange

Doctoral Dissertations

As the U.S. older adult population increases and diversifies, healthcare providers need innovative, cost-effective, and culturally congruent approaches to gerontological nursing care. Decades of multidisciplinary evidence demonstrate that spirituality enhances older adult holistic health. However, although research about spirituality and nursing has become more culturally diverse, little is known about spirituality-health linkages of rural Appalachian older adults (RAOAs). This knowledge gap is significant because Appalachia leads the country in mortality related to chronic comorbidities such as heart disease, cancer, and depression. Given age, poverty, limited transportation, and health provider shortage areas, RAOAs experience severe health disparities. Moreover, spirituality is an …

Anxiety-Like Behavior In C57bl/6j Mice Is Sexually Dimorphic And Altered By Buprenorphine, Ohm Sharma

Chancellor’s Honors Program Projects

No abstract provided.

Ballad Health: Understanding Appalachia’S Regional Healthcare Monopoly, Meredith A. Bailey

Baker Scholar Projects

The Ballad Health merger of 2018, which combined the now 21 hospitals in the region under one organization, has impacted the healthcare landscape in Northeast Tennessee and Southwest Virginia. Historically, Appalachia has had to persevere through primary physician shortages, a lack of specialty care, geographic obstacles to accessing healthcare, challenges related to substance abuse, and much more. Since the merger of Mountain States Health Alliance and Wellmont Health System, little research has been done to assess the perceived impact the aggregation of providers has had on the population it serves. This study utilizes an online survey to better understand the …

The Pink Tax: A Comparative Case Study Between Tennessee And Washington State, Megha Chitturi

Baker Scholar Projects

The imposition of an additional luxury tax on menstrual health products, otherwise referred to as the “Pink Tax” or the “Tampon Tax”, is present in some states while absent in others. The decision to repeal such a tax is one that has proven to be critical, as it removes the connotation that such products are of “luxury” and make them more accessible to menstruators throughout the state. As of 2023, twenty-three states have eliminated the tax. The state of Washington falls under that parameter while Tennessee does not. The purpose of this undergraduate honors thesis is to explore the potential …

The Development Of Health System Resiliency: How Kenya's Experience With Malaria Impacted Its Reaction To The Covid-19 Pandemic, Zoe A. Ward

Baker Scholar Projects

Public health scholars have recently focused on health system resiliency to explain how previous experiences dealing with public health crises impact the healthcare sector, public behavior, and policy response to novel crises. However, it is unclear how resiliency develops. This study contributes by testing whether a health system’s experience with a health emergency and significant interventions impacts the response to a novel crisis. This research asks, “How has Kenya’s experience with malaria impacted its response to COVID-19?” Using the United States Agency for International Development (USAID) Malaria Indicator Survey (MIS), I develop a malaria adherence score to measure county-level compliance …

When The Rural Hospital Closes: An Analysis Of Acute Health Impacts Following Closure Of Rural Hospitals In Appalachia, Bret M. Berry

Chancellor’s Honors Program Projects

No abstract provided.

The Practice Environment For Nurse Anesthetists In Tennessee, Taylor Cathey, Jessica Hobbs, Matthew Owen, Alexis Varney, James Alberding, Tausha Alexander

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Potential consequences of anesthesia provider shortages may include a reduction in health care access, poor patient outcomes, and increased costs to government funded agencies. Current leaders in the anesthesia profession need to establish a work environment that is embracing, supportive, and safe so that certified registered nurse anesthetists (CRNA) can remain healthy and productive. The purpose of this Doctor of Nursing Practice (DNP) scholarly project was to provide an overview of the current CRNA practice environment in Tennessee and advocate for policies to promote CRNA retention and enhance patient access to care. The overarching goal included gathering sufficient evidence regarding …

Intra-Skeletal Variation In Stable Isotopes Through Non-Destructive Approaches: Applications Of The Patterns Of Skeletal Remodeling To Biological Anthropology, Armando Anzellini

Doctoral Dissertations

Stable isotope analysis is a well-established method in biological anthropology used to deliver data on residence, diet, and life history. Samples for these analyses are often collected from the diaphyses of long bones with an assumption of an expected rate of turnover between five and ten years, depending on the skeletal element. However, the biological foundations of this assumption are still uncertain, especially concerning the intra-skeletal and intra-element variation of isotopic signatures that may relate to patterns of remodeling. Exploring these gaps in intra-element isotopic variation requires fine-grained work using multiple bones from multiple individuals, but such work is limited …

Sphenoidal Sinuses And Spherical Harmonics: Variation And Covariation Of The Most Morphologically Diverse And Least Understood Paranasal Sinus, Katharine Grace Josephine Ryan

Doctoral Dissertations

Understanding the shape variation of the human sphenoidal sinus is important to several areas of research. This includes clinical investigation (sinus pathology and safe endoscopic endonasal surgical practice) and paranasal sinus evolution (for which there is still no consensus). Yet, the sphenoidal sinus has high morphological variation, prohibiting its quantification through traditional geometric morphometric landmarking methods. The sphenoid body, and thus also the sinus contained within, is located directly at the developmental center of the basicranium in humans, where the three cranial fossae meet at the midline, and adjacent to the three synchondroses which are the sites of cranial base …

Genealogy Tells: Informing Health And Aging Policies Using East Tennessean Older Women's Family Histories, Perceptions, And Experiences Of Health Inequity, Heather Davis

Doctoral Dissertations

Older women face unique health inequities challenges. This study aims to provide an understanding of older women’s perceptions and situated experiences regarding the gendered health inequities they face and the social determinants (SDH) thereof. It examines how these health inequities are situated in older women’s genealogical (familial) and geographical health and mortality outcomes histories and how their perceptions and experiences of health inequities and their familial mortality outcomes histories are characterized by the geopolitical and social norms in which they live. The purpose of this project is to present policy and decision-makers with insights about and recommendations from older women …

Investigating Person-Specific Profiles Of Readiness-To-Exercise: Exploring Associations With Hypothetical Experiential Outcomes And Perceived Relevance, Cory Beaumont

Doctoral Dissertations

Autoregulation is a person-adaptive strategy wherein exercise workloads are adjusted to match one’s readiness (e.g., acute mental, physical, perceptual state). Prior work demonstrated that structural features of readiness profiles (i.e., which factor(s) are most important) differ across individuals. As this work relied on mathematical modeling, research is needed to understand the informational utility of person-specific profiles (PSPs) of readiness. Purpose: Model heterogeneity in PSPs of readiness (Aim 1), explore associations between PSP factor scores and forecasted experiences to hypothetical muscle-strengthening exercise (Aim 2), and explore participants’ perceptions of relevance and utility regarding their PSP (Aim 3). Methods: For …

A Qualitative Exploration Of Upsr, Shelby Miller

Masters Theses

Person-Centered Theory (PCT, Rogers, 1959) provides the understanding of how growth-promoting relationships facilitate holistic well-being through the provision of unconditional positive regard (UPR), genuiness, and empathy. Through coaches’ provision of UPR, athletes have reported experiencing an increase of motivation, enhanced performances, and greater trust in their coach (McHenry et al., 2022). Most intriguingly, athletes created a relationship with themselves (i.e., self-regard) that mirrored their coaches’ treatment of them (McHenry et al., 2021). While UPR has just recently been studied in the coach-athlete relationship, little to no attention has been given to the relationship an athlete has with themselves (i.e., self-regard). …

Depression, Anxiety, And Stress Severity Impact Social Media Use And Tiktok Addiction, Skylar L. Maguire, Hollie Pellosmaa

Chancellor’s Honors Program Projects

No abstract provided.

Design And Development Of The Urban Population Health Observatory To Improve Disease Surveillance And Response, Whitney Brakefield

Doctoral Dissertations

Chronic and infectious diseases have a profound impact on the quality and length of life of populations that suffer from these conditions. Scientists, physicians, and health officials are seeking innovative approaches to decrease the morbidity and mortality of deadly diseases. Incorporating artificial intelligence and data science techniques across the health science domain could improve disease surveillance, intervention planning, and policymaking. In this dissertation, we describe the design and development of the Urban Population Health Observatory (UPHO), an explainable knowledge-based multimodal big data analytics platform. A common challenge for conducting multimodal big data analytics is integrating multidimensional heterogeneous data sources, which …

“In The Skin I’M In…I Represent A Different Version Of What Help Looks Like:” Black Women Sport Psychology Professional’S Experiences In Applied Sport Psychology, Sharon R. Couch

Doctoral Dissertations

Black Feminist Applied Sport Psychology (BFASP) is a culturally inclusive theoretical framework for centering Black women’s experiences in applied sport psychology (Carter et al., 2020; Couch et al., 2022). For the past two decades, (White) Feminist applied sport psychology professionals (FASPPs) described the experiences of Black women as unique but were overlooked in research and participant pools due to the prioritization of White women's and Black male sport experiences. (Carter & Davila, 2017; Carter & Prewitt-White, 2014; Gill, 2020; Hyman et al., 2021). The purpose of this study was to explore the life and work experiences of BASPPs (i.e., faculty, …

Impact Of Enhanced Communication Techniques On Pediatric Patient Outcomes, William L. Baker

Chancellor’s Honors Program Projects

No abstract provided.

Tennessee’S Covid-19 Response: The Relationship Between Case Numbers And Public Opinion, Chandni Naidoo

Chancellor’s Honors Program Projects

No abstract provided.

Understanding Autonomy And Positionality In Obstetric Care Outcomes For Queer Individuals, Juliana K. Upchurch

Chancellor’s Honors Program Projects

No abstract provided.

Creating A Backyard Buzz: Evaluating The Effectiveness Of Using A Video Infographic To Increase Knowledge About Mosquito Populations And Diseases In Tn, Caroline M. Barnes, Rebecca T. Trout Fryxell, Cristina Barroso, Julie Andsager

Chancellor’s Honors Program Projects

No abstract provided.

Promoting Nurse Well-Being During A Global Pandemic Through The Community Resiliency Model, Sherissa Manganello

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Since the COVID-19 pandemic started a few years ago, there has been an increase in mental health issues due to the chronic emotional, physical, and psychological stress that everyone has had to endure. COVID-19 has had long-lasting consequences on the entire healthcare system, especially with nurses as the foundation for providing quality patient care. While nurses are the trusted professionals, they also have one of the most emotionally and physically demanding careers (Ward-Miller et al., 2020). In addition, there is a global health crisis of nursing shortages that continues to grow through COVID-19, which directly affects patients’ quality of care …

Continued Use Of Retracted Publications: Implications For Information Systems And Scientific Publishing, Peiling Wang, Luke Baker Mccullough, Jing Su

School of Information Sciences -- Faculty Publications and Other Works

Reports on the preliminary results of an empirical study of post-retraction citations of biomedical research literature. Retractions of biomedical publications have a serious impact on research enterprise and public health. Retractions to correct literature and alert readers are actions by the journals based on evidence of serious flaws or errors or upon the request of the authors. The process of retraction could take a few weeks or years after publication. The purpose of this study is to investigate how retracted peer-reviewed journal articles were cited post-retraction. Post-retraction citing articles are those published two years after the retraction year. The dataset …

Expert Recommended Biomedical Journal Articles: Their Retractions Or Corrections, And Post-Retraction Citing, Peiling Wang, Jing Su

School of Information Sciences -- Faculty Publications and Other Works

Faculty Opinions has provided recommendations of important biomedical publications by domain experts (FMs) since 2001. The purpose of this study is two-fold: 1) identify the characteristics of the expert-recommended articles that were subsequently retracted; 2) investigate what happened after retraction. We examined a set of 232 recommended, later retracted or corrected articles. These articles were classified as New Finding (43%), Interesting Hypothesis (16%), etc. More than 71% of the articles acknowledged funding support; the NIH (US) was a top funder (64%). The top reasons for retractions were Errors of various types (28%); Falsification/fabrication of data, image, or results (20%); Unreliable …

Religiosity And Ways Of Coping With Sport Injuries Among Christian Athletes, Diane M. Wiese‐Bjornstal, Kristin N. Wood, Francesca M. Principe, Emma S. Schwartz

Movement and Being: The Journal of the Christian Society for Kinesiology, Leisure and Sports Studies

Although research evidence supports religiosity’s predominantly positive mental and physical health benefits to patients coping with varied health problems, there are few studies exploring the influence of religiosity on coping with sport injuries among athletes identifying with specific religions. This study examined the relationships between religiosity and the use of religious and non-religious ways of coping with sport injuries by athletes affiliated with diverse Christian denominations. Within a concurrent mixed methods design, adult athletes (N = 88) responded to an online survey asking about several religiosity factors, their most serious or challenging sport injuries, and their ways of coping …

Nuclear Security Awareness Survey At A University, Marcia P. Robinson, Naomi German, Destiny B. White, Shraddha V. Rane, Jason Timothy Harris

International Journal of Nuclear Security

The concept of assessing safety culture in an organization emerged with its application at the nuclear power industry and has expanded since then. An assessment of nuclear security, on the contrary, is still under-developed, especially at non-nuclear facilities, such as academic institutions and medical facilities. To identify the level of the awareness and understanding of credible nuclear and radiological threats, response preparedness, security culture, and the integrity of nuclear security systems among non-radioactive material users at a university setting; a campus-wide survey was deployed. A total of 3,336 non-radioactive material users, including students, faculty, and staff participated in the survey. …