Medicine and Health Sciences Commons^™

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 …

Determining Patient Activation Levels Among Patients Who Are Receiving Rehabilitation Services In A Rehabilitation Or Long-Term Care Facility, Danielle S. Vittatoe

Undergraduate Honors Theses

Research shows that one of the major contributors for an extended stay in a long-term care facility is lack of knowledge regarding goals for rehabilitation after being discharged from an acute care facility. It is important to determine patients’ levels of engagement because individuals who are actively involved in discharge planning and rehabilitation goals are able to manage their ongoing care more effectively, which results in increased quality of life. The data was collected using a survey method and the instrument used was the Patient Activation Measure or PAM which is a highly accurate and reliable tool. The 22 question …

What Do Veterans With Posttraumatic Stress Disorder Experience In Receiving Care In Appalachia, Brittany L. Thomas

Undergraduate Honors Theses

This qualitative research study explores what veterans living in the Appalachian region experience in receiving care for Posttraumatic Stress Disorder through personal interviews. These interviews will give insight into how veterans in Appalachia perceive their care through specific questions pertaining to healthcare for Posttraumatic Stress Disorder.

A convenient sample of veterans attending the specific study site was used for this study. An email, which contained information about the background and nature of the study was used for participant recruitment of veterans. In addition, flyers with the same information were posted throughout the study site. This study will highlight specific details …

Redesign Of Trans-Splicing Molecules For The Correction Of Dystrophia Myotonica Type 1 Toxic Rna Transcripts, Eleanor G. Harrison

Undergraduate Honors Theses

Dystrophia myotonica (DM1), one of the most common forms of muscular dystrophy, is caused by a repeated trinucleotide expansion in the DMPK gene. This mutation results in the accumulation of toxic cellular RNA transcripts. Spliceosome-mediated RNA trans-splicing (SMaRT) technology is a form of gene therapy that possesses the potential to correct these toxic RNA transcripts and thus cure the disease. Despite its promise, prior research applications of SMaRT technology to DM1 have been hampered by poor efficiency and have not been validated in a relevant model of the disease. In order to improve the efficiency of trans-splicing, this study examined …

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 …

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 …

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 …

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, …

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 …

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 …

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 …

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 …

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 …

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 …

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 …

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 …

Examining General Versus Condition-Specific Health Related Quality Of Life Across Weight Categories In An Adolescent Sample, Autumn G. Dalton

Undergraduate Honors Theses

Approximately 34% of adolescents are overweight or obese which can be accompanied by physical, psychosocial, and economic consequences. Increasingly, pediatric overweight/obesity research has focused on Health Related Quality of Life (HRQoL) as a health outcome. This study examined differences in HRQoL across weight categories in adolescents, specifically, the sensitivity of using a general versus condition-specific measure. Further, the influence of gender was explored.

Data were extracted from Wave 2 of Team Up for Healthy Living, a school-based obesity prevention program targeting adolescents in Southern Appalachia. Participants (N = 918; 50% Female; 93% Caucasian; 90% 9^th graders) completed …

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 …

A Systematic Column Performance Comparison For The Confirmation Of Opioids Used In Pain Management By Lc-Ms, Derek Stallard

Undergraduate Honors Theses

In this study, three different chromatographic column chemistries (C18, Pentafluorophenyl (PFP), Hydrophilic Interaction Chromatography (HILIC)) were compared under optimal conditions to determine which stationary performed best in the separation and detection of a mixture of opioids using LC-MS. Furthermore, these stationary phases were examined in three different column technologies – traditional silica, porous shell, and porous polymer (PRP). The PRP column had the best peak shape for all 13 opioids and dominated for later-eluting compounds. In terms of column reproducibility, the Hamilton C18 column had the lowest %RSD values. The Kinetex HILIC produced the most theoretical plates and best resolution …

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: …

Rural Pediatric Primary Care Practice Patterns As A Result Of An On-Site Behavioral Health Consultant: A Retrospective Analysis, Kayla D. Mccarter

Undergraduate Honors Theses

Nationally, it has been estimated that 10 to 21% of children with psychosocial concerns are seen in primary care settings (Jellinek et al., 1999; McInerny, Szilagyi, Childs, Wasserman & Kelleher, 2000; Palermo et al., 2002). Often, however, children go undiagnosed with/treated for psychosocial concerns in pediatric primary care due to lack of physician time and poor referral rates to mental health providers. Evaluations of integrated care models, in which a behavioral health consultant is present in primary care practices, has shown to increase the availability of mental health services (Stancin, Perrin, & Ramirez, 2009). Using extant data from patient records …

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 …

Birthing Positions: Is There A Connection Between Acutal Nursing Experience And Evidence-Based Research?, Leah M. Latham

Undergraduate Honors Theses

The objectives of this study were to determine whether there was an association between clinical nursing knowledge of four birthing positions and current evidence-based research of those same positions and also to identify possible areas where nursing knowledge of those birthing positions was inadequate. This pilot study used convenience sampling to survey registered nurses (RNs) and licensed practical nurses (LPNs) on labor and delivery units. The survey was distributed to three hospitals in the southeastern United States, and twenty-four RNs and LPNs participated. Participants’ knowledge did not reflect current clinical evidence in two key areas, (1) the best position to …

The Impact Of Inappropriate Gestational Weight Gain On Pregnancy, Delivery, And Neonatal Outcomes, Morgan L. Isom

Undergraduate Honors Theses

Inappropriate weight gain during pregnancy is a widespread problem associated with adverse maternal and newborn outcomes. This study’s objective was to examine the impact of gestational weight gain (GWG) above and below the Institute of Medicine (IOM) guidelines on pregnancy, delivery, and newborn outcomes in a rural population. Women were recruited at the first prenatal visit, and data was collected through research interviews and examination of prenatal and delivery medical records. Prepregnancy weight and weight at delivery were obtained, and the final sample (n=913) was restricted to women with singleton pregnancies. Participants were categorized by prepregnancy body mass index (BMI) …

9-Phenanthrol And Flufenamic Acid Inhibit Calcium Oscillations In Hl-1 Mouse Cardiomyocytes, Rees A. Burt

Undergraduate Honors Theses

Electrical potentials exist across the membranes of nearly every cell type in the body. In addition, excitable cells, such as neurons, myocytes and even some endocrine cells elicit electrochemical fluctuations, action potentials (AP), in the cell membrane to initiate cell-to-cell communication or intracellular processes. The basis for the electrical potential is rooted within an array of complex interactions between monovalent ions and their associated membrane channels and transporters that regulate the flux of these charged species across the hydrophobic bilayer. Here, an expansion of our recently published work [1] will serve to explore the modern concepts regarding the …

Neuromodulation Therapy Mitigates Heart Failure Induced Hippocampal Damage, Timothy P. Diperi

Undergraduate Honors Theses

Cardiovascular disease (CVD) is the leading cause of death in the United States. Nearly half of the people diagnosed with heart failure (HF) die within 5 years of diagnosis. Brain abnormalities secondary to CVD have been observed in many discrete regions, including the hippocampus. Nearly 25% of patients with CVD also have major depressive disorder (MDD), and hippocampal dysfunction is a characteristic of both diseases. In this study, the hippocampus and an area of the hippocampal formation, the dentate gyrus (DG), were studied in a canine model of HF. Using this canine HF model previously, we have determined that myocardial …

Measuring The Effects Of Ctrp3 And Metformin On H4iie Hepatocyte Metabolism Using Seahorse Extracellular Flux Analyzer, Forrest J. Longway

Undergraduate Honors Theses

Non-alcoholic fatty liver disease (NAFLD) results from an unequal uptake/storage and export/oxidation of lipids within the liver and is often a secondary disease to type II diabetes (22). NAFLD causes this imbalance of lipids by altering glucose and lipid metabolism, which corresponds to a decrease in mitochondrial function leading to failure of the liver. One established treatment for type II diabetes and NAFLD is the drug metformin, which has similar properties to the newly discovered CTRP 3 protein which is part of a group of bioactive molecules secreted by adipose tissue, collectively termed adipokines (2-4). Both have similar effects on …

Portion Size Selection In Relation To Hemoglobin A1cs, Brian L. Dixon

Undergraduate Honors Theses

Obesity has been recognized as an increasing issue within our country. Obesity contributes to many health related issues, including type 2 diabetes mellitus. Portion size is a factor that has generated clinical research interest. The aim of this study was to determine if there was a relationship between management of diabetes measured by hemoglobin A1c and portion size selection for type 2 diabetics. In this study, subjects selected portion sizes of four different foods. Data were compared to recent A1c levels. Due to the small sample size, nonparametric statistical analysis was used. The relationship of grain portion weight selection and …