Medicine and Health Sciences Commons^™

Collaborative Models Of Care In The Appalachian Region Of Tennessee: Examining Relationships Between Level Of Collaboration, Clinic Characteristics, And Barriers To Collaboration, Jeffrey Ellison

Electronic Theses and Dissertations

Decades of research have shown that there are significant advantages to maintaining close communicative and collaborative relationships between primary care and behavioral health providers. Fiscal, structural, and systemic barriers, however, often restrict the degree to which such interprofessional collaboration can occur. In the present study the authors examined relationships between primary care clinics in the Appalachian region’s characteristics (i.e., clinic type, rurality, and clinic size), barriers (i.e., fiscal, structural, and systemic) reported to using increased collaboration, and the level of collaboration used at a particular clinic.

For the present study 136 surveys were completed by providers working in primary care …

The Effects Of Vertically-Oriented Resistance Training On Golf Swing Performance Variables, Austin R. Driggers

Electronic Theses and Dissertations

The purpose of this study was to examine the effects of vertically-oriented resistance training on golf driving performance. Ten Division-I collegiate golfers completed 2 resistance training sessions per week for 10 weeks during the fall tournament season. Pre- and posttraining assessments of strength-power and golf performance were compared. To assess strength-power, jump height, peak force, and peak power (PP) were measured from static and countermovement (CMJ) vertical jumps; peak force and rate of force development from 0-250 ms were measured from an isometric mid-thigh pull. Golf performance was assessed in terms of ball launch speed (BS), spin rate, carry yardage …

Therapeutic Camps And Their Impact On The Family Of Children With Special Health Care Needs: A Mixed Method Study, Brandi Lindsey

Electronic Theses and Dissertations

Children with a chronic illness or disability can encounter many difficulties throughout their lifetimes. Respite care through therapeutic summer day camps is a service used to relieve the physical and mental strains placed on caregivers while also creating unique opportunities to benefit the child. There are gaps in the literature surrounding therapeutic camps and their benefit for the family and their ability to manage the child’s special health care need. The purpose of this study is to determine how respite care in the form of a therapeutic summer day camp for children with special needs impacts a family’s ability to …

Assessing The Social And Ecological Factors That Influence Childhood Overweight And Obesity, Katie Callahan

Electronic Theses and Dissertations

The prevalence of childhood overweight and obesity is increasing at an alarming rate in the United States. Currently more than 1 in 3 children aged 2-19 are overweight or obese. This is of major concern because childhood overweight and obesity leads to chronic conditions such as type II diabetes and tracks into adulthood, where more severe adverse health outcomes arise. In this study I used the premise of the social ecological model (SEM) to analyze the common levels that a child is exposed to daily; the intrapersonal level, the interpersonal level, the school level, and the community level to better …

Regulation Of C-Reactive Protein Gene Expression And Function, Avinash N. Thirumalai

Electronic Theses and Dissertations

Human C-reactive protein (CRP) is the prototypic acute phase protein whose serum concentration increases rapidly during inflammation. CRP is also associated with atherosclerosis; it is deposited at lesion sites where it may interact with modified lipoproteins. There are 2 major questions regarding CRP: 1. How is the serum concentration of CRP regulated? 2. What are the functions of CRP in atherosclerosis?

Our first aim was to determine the role of the constitutively expressed transcription factor Oct-1 in regulating CRP gene expression. We found that Oct-1 overexpression inhibited (IL-6+IL-1β)- induced CRP gene expression; maximal inhibition required the binding of Oct-1 to …

Nicu Culture Of Care For Infants With Neonatal Abstinence Syndrome: A Focused Ethnography, Monica M. Nelson

Electronic Theses and Dissertations

Purpose: The purpose of this ethnographic study was to describe the culture of care and nonpharmacological nursing interventions performed by NICU nurses for infants with NAS. Background: Infants with NAS are increasingly being cared for in the inpatient hospital setting by NICU nurses. Interventions used for the care of premature and sick infants in the NICU may or may not be the exact interventions that should be used for the care of the fragile infant with NAS. Research studies on the nonpharmacological nursing care of infants with NAS encompass 5 main areas of practice: environment, adequate rest and sleep, feeding, …

Mental Health Referral In Primary Care: Influence Of A Screening Instrument And A Brief Educational Intervention, Michael T. Miesner

Electronic Theses and Dissertations

Although less than half of all patients with mental disorders seek mental health treatment per se, approximately 80% of all people will visit their primary care physician (PCPs) within a year (Strosahl, 1998). However, it is not well understood how to best handle patients presenting with mental health issues in primary care practices. The purpose of this project was to implement an intervention involving a screening measure for anxiety and mood disorders in a primary care setting to increase the volume of anxiety and mood disorder screening, to increase the accuracy of disorder detection, and to also enhance PCPs patterns …

Coach And Athlete Perceptions Of An Athlete Monitoring And Strength And Conditioning Program, Jacob P. Reed

Electronic Theses and Dissertations

Purpose: The purpose of this investigation was to assess athlete perceptions of an athlete monitoring program throughout an academic year and coach perceptions throughout a competitive season. The secondary purpose was to develop a questionnaire designed to assess coach and athlete perceptions of the monitoring program. Methods: Athletes and coaches participating in the athlete monitoring program at East Tennessee State University’s (ETSU) Sport Performance Enhancement Consortium (SPEC) were invited to participate. Reliability for the coach and athlete questionnaires and principle components analysis (PCA) of the athlete questionnaire was completed after initial development of the questionnaire (11 questions for athletes and …

Examining The Influence Of Farmers' Market Motivations On Access To Healthful Foods And Business Opportunities For Farms, Rachel K. Ward

Electronic Theses and Dissertations

Farmers’ markets are increasingly promoted as mechanisms for improving access to healthful foods for low-income households, as they are relatively inexpensive to establish and they can provide affordable food for low-income households by offering Supplemental Nutrition Assistance Program Electronic Benefit Transfer (SNAP/EBT). SNAP/EBT at markets also expands revenue opportunities for participating farmers. Market mangers provide a critical role in overseeing SNAP/EBT at markets and influencing business opportunities for farmers. Using a mixed-method approach, this study aimed to evaluate how managers’ motivations influence SNAP/EBT availability and participation at markets and business opportunities for small- and moderate- sized farms.

To develop a …

Physical And Technical Demands Of Women’S Collegiate Soccer, Ryan Alexander

Electronic Theses and Dissertations

The purpose of this dissertation was to explore the physical and technical demands of the women’s college soccer game through a case study approach. With advancements in technology, motion analysis has become commonplace in most professional environments. However, the literature on amateur soccer is quite scarce and warrants more attention. The aims of this dissertation were: 1) to describe the physical demands of each position for a women’s college soccer player as they relate to total distance covered, efforts, and distance covered in high-speed velocity bands, 2) explore the variation in physical performance during a competitive season, and 3) compare …

Assessing Health Department Readiness For Public Health Accreditation Through Quality Improvement, Christian L. Williams

Electronic Theses and Dissertations

Engaging in quality improvement (QI) activities can help local and state health departments improve current processes, develop more effective new processes, increase leadership capacity, and prepare for public health accreditation. Public health organizations that have implemented QI processes have seen improvements in health outcome indicators, delivery of the 10 essential services, patient satisfaction, and performance management.

Quality improvement is the foundation of the Public Health Accreditation Board‟s (PHAB) program and further pushes health departments, at both the local and state level, to adopt QI activities within their organizations. There are numerous potential benefits associated with accreditation in public health, one …

Lower Body Strength And Power Characteristics Influencing Change Of Direction And Straight-Line Sprinting Performance In Division I Soccer Players: An Exploratory Study, Chieh-Ying Chiang

Electronic Theses and Dissertations

The purpose of this dissertation was to investigate the influence of lower body strength characteristics on change of direction (COD) performance in NCAA Division I soccer athletes. Specifically, this dissertation served to examine: 1) whether the lower body strength and power were related to COD performance, 2) whether stronger athletes had superior COD performance than weaker athletes, 3) whether the force production asymmetry and strength dominant (SD) associated with COD performance, and 4) weather sex differences existed in kinetic variables during the stand phase of cutting.

The major findings of this dissertation include: 1) strength and power characteristics were moderately …

Exploring The Role Of Religiosity On Suicidal Ideation: A Study Among A Population-Based Sample Of Adolescents In The United States, Grace E. Tettey

Electronic Theses and Dissertations

Suicide is a major public health issue in the United States. Some studies show decreased suicide rates in religious populations, but it is unclear how religiosity might be linked to suicidal behavior of adolescents emerging into adulthood. To this point few studies have examined the relationship between adolescent suicidal ideation and several risk factors at once and the role of religiosity in these relationships.

Drawing from Waves I-III of the National Longitudinal Survey of Adolescent Health data from 1994 to 2002, I sought to explore the relationship between religiosity (i.e. religious affiliation, service attendance, prayer, perceived importance of religion) and …

Physical And Performance Characteristics May Influence Successful Completion Of Military Tasks On The Sandhurst Competition, Keith A. Leiting

Electronic Theses and Dissertations

Identification and development of physical characteristics that lead to efficient performance of military skills or tasks has been a consistently difficult task for the United States military for decades. The literature suggests certain physical characteristics may be more important, although this information is conflicting. Furthermore, the military physical fitness training program that is intended to prepare soldiers for combat is commonly evaluated with the Army Physical Fitness Test (PFT), a test that is more suited for evaluating health and wellness rather than task-specific fitness. All of this testing and training of soldiers focuses on the individual soldiers and their abilities …

Effects Of Music Intervention On The Patient’S Perception Of Pain After Knee Replacement Surgery, Heather E. Hooks

Electronic Theses and Dissertations

The purpose of this study was to determine whether therapeutic music affects the patient’s perception of pain, postoperative day 1 after knee replacement surgery in an inpatient hospital. In addition to the patient’s pain levels, the study was an analysis of the quantity of opioids the patient was requested, the length of stay, and the physiological parameters, which included blood pressure, heart rate, respiratory rate, and oxygen saturation. Sixty knee replacement patients were randomly placed in the music group or the quiet group. The Faces Pain Scale Revised with Numeric Rating Scale was used to measure pain levels. Statistical analysis …

Physiologically-Based Pharmacokinetic Model For Ertapenem, Whitney Forbes

Electronic Theses and Dissertations

Ertapenem is a carbapenem used to treat a wide range of bacterial infections. What sets ertapenem apart from other carbapenems is its longer half-life which implies it need only be administered once daily. We developed a physiologically-based pharmacokinetic model for the distribution of ertapenem within the body. In the model, parameters such as human body weight and height, age, organ volumes, blood flow rates, and partition coefficients of particular tissues are used to examine the absorption, distribution, metabolism, and excretion of ertapenem. The total and free blood concentrations found were then compared to experimental data. We then examined the sensitivity …

Dietary Counseling Practices And Perceived Barriers Among Utah Dental Hygienists, Natalie F. Carlson

Electronic Theses and Dissertations

Diet related factors are associated with the 2 most prevalent oral diseases- caries and periodontal disease. Furthermore, there is growing evidence of a synergistic link between nutrition, systemic health, and oral health. Regardless of this evidence and in spite of recommendations by dental associations, researchers have shown the majority of dental professionals are consistently excluding nutritional screenings and dietary counseling in their dental services. The purpose of this study was to examine the nutritional screening and dietary counseling practices of Utah dental hygienists and to evaluate possible associations between various factors influencing the implementation of nutritional services. Surveys were collected …

Extracellular Ubiquitin: Role In Cardiac Myocyte Apoptosis And Myocardial Remodeling, Christopher Ray Daniels

Electronic Theses and Dissertations

Activation of sympathetic nervous system is a key component of myocardial remodeling that generally occurs following ischemia/reperfusion (I/R) injury and myocardial infarction. It induces cardiac myocyte apoptosis and myocardial fibrosis, leading to myocardial dysfunction. Intracellular ubiquitin (UB) regulates protein turnover by the UB-proteosome pathway. The biological functions of extracellular UB in the heart remain largely unexplored. Previously, our lab has shown that β-adrenergic receptor (β-AR) stimulation increases extracellular UB levels, and extracellular UB inhibits β-AR-stimulated apoptosis in adult rat ventricular myocytes (ARVMs). This study explores the role of extracellular UB in myocyte apoptosis, fibroblast phenotype and function, and myocardial remodeling …

Assessment Of Red Blood Cell Membrane Fatty Acid Composition In Relation To Dietary Intake In Patients Undergoing Cardiac Catheterization, Nicole S. Litwin

Electronic Theses and Dissertations

Red blood cells (RBC) have been shown to mediate plaque development seen in coronary artery disease (CAD). This study determined whether differences in RBC fatty acid (FA) composition were related to CAD risk. FAs were extracted from RBCs of 38 individuals who have undergone cardiac catheterization, 9 of whom had obstructive CAD, and analyzed via gas chromatography. Ferric reducing ability of plasma (FRAP) assay was used to determine oxidative stress. Food frequency questionnaires were used to correlate RBC omega-3 FA to daily intake of omega-3 FA. No correlation was found between RBC content and intake of omega-3 FA. FRAP values …

Survey Of Dental Hygienists’ Attitudes And Support Of The Proposed Dually Accredited Advanced Dental Therapist, Deborah S. Mcbride

Electronic Theses and Dissertations

The proposed dually licensed advanced dental therapy program, a graduate level curriculum created by the American Dental Hygienists’ Association (ADHA) encompassing both dental hygiene and basic restorative procedures, creates an innovative career path in dental hygiene and increases the standing of the dental hygienist from an auxiliary role to an independent midlevel dental practitioner. Data were gathered via an online anonymous survey tool from Massachusetts registered dental hygienists to assess support of this proposed curriculum by practicing hygienists. Eighty-seven percent of survey respondents are in agreement that the scope of dental hygiene responsibilities should increase with level of education, and …

Hand Function Evaluation For Dental Hygiene Students, Sara Taft

Electronic Theses and Dissertations

Dental hygiene students may struggle in dental hygiene curriculum in regards to hand function. Currently, this is not an aspect dental hygiene programs screen for or have protocol in place to help students. The research in the study examined if hand function could improve with hand function exercises and if exercises improved instrumentation scores. During a 6-week pilot study, an occupational therapist tested the hand function of a cohort of dental hygiene students. The results were recorded and the students began a 6-week hand function exercise regimen. After 6 weeks the same evaluations were preformed and the pre- and posttest …

Novel Therapeutic Approaches For Ischemic Heart And Brain Injury: Modulation Of Toll-Like Receptor-Mediated Signaling Pathways And Pi3k/Akt Signaling, Chen Lu

Electronic Theses and Dissertations

Innate immune and inflammatory responses contribute to myocardial and cerebral ischemia/reperfusion (I/R) injury. Toll-like receptors (TLRs) play a critical role in the induction of innate immune and inflammatory responses via activation of nuclear factor kappa B (NF-κB). We have shown that activation of NF-κB contributes to myocardial and cerebral I/R injury. Indeed, inhibition of TLR4-mediated NF-κB activation significantly decreased myocardial and cerebral I/R injury via activation of PI3K/Akt signaling. PI3K/Akt signaling is an important pathway in regulating cellular survival and inflammatory responses. Therefore, an important question is how to differentially modulate PI3K/Akt signaling and TLR/NF-κB-mediated signaling pathway during I/R injury? …

Evaluation Of Key Components Of Draft Guidelines For The National Weather Service Tsunamireadytm Community Program, Colleen Scott

Electronic Theses and Dissertations

The National Tsunami Hazard Mitigation Program partnered with the National Weather Service (NWS) in 2000 to create the TsunamiReady^TM (TR) Community program. TR is designed to help communities in coastal areas plan and prepare for tsunamis. To achieve TR recognition communities must meet certain criteria including specific emergency planning and management actions within the categories of mitigation, preparedness, response, and recovery.

This study’s purpose was to evaluate the acceptability and usefulness of key components of a proposed revised set of TR Community program guidelines. Research was guided by the Elaboration Likelihood Model (ELM) using Community Based Participatory Research methods …

Vitamin D Status Of College Students: Implications For Health Leaders, Eileen M. Cress

Electronic Theses and Dissertations

Vitamin D deficiency is considered to be a pandemic with implications for compromised bone health and other chronic diseases. Few studies have examined vitamin D status in college-aged individuals where prevention of future health consequences is still possible. Serum vitamin D 25(OH)D status and vitamin D intake were examined in 98 college students ages 18-29 years during winter. BMI was classified as < 25and 25 or greater. Race was categorized as Caucasian or other. Overall, 69.5% had suboptimal serum vitamin D levels, <30ng/mL. Only 8 students (8.2%) met the EAR (400 IU) per day for vitamin D intake. t tests were used to determine if there were significant differences in serum vitamin D level and dietary intake based on gender, race and BMI. Significant differences were found in serum vitamin D level when compared by gender and race. Females tended to have a higher serum vitamin D level than males. Those representing minorities had lower serum vitamin D levels than Caucasians; One hundred percent of the minority students had suboptimal serum vitamin D levels. Based on these findings, dietitians should increase efforts to target college-aged individuals in educational programming related to factors affecting vitamin D synthesis, vitamin D intake, and health consequences of suboptimal vitamin D status, particularly in winter. Consideration should be given to vitamin D fortification of foods that meet the preferences of today’s consumer.