Medicine and Health Sciences Commons^™

Job Embeddedess Of Nurses Working In South Central Appalachia’S North Carolina Counties, Susan L. Adams Mrs.

Electronic Theses and Dissertations

Nurses working in the North Carolina counties of South Central Appalachia (NC-SCA) are a unique subset of nursing professionals. A continued nursing shortage is projected in this area while staffing has improved in other areas of SCA. The purpose of this research was to ascertain the level of job embeddedness of nurses working in NC-SCA in order to offer guidance regarding retention of nurses working in this area. Actively working licensed practical nurses, registered nurses, and advanced practice nurses (nurse practitioners, certified nurse midwives, clinical nurse specialists, and certified registered nurse anesthetists) from 29 North Carolina counties included in South …

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 …

Effects Of Lower Extremity Aerobic Exercise And Conditioned Pain Modulation On Evoked Shoulder Pain, Logan Lumpkins, Craig Wassinger

Undergraduate Honors Theses

Background: Emerging evidence suggests that aerobic exercise and conditioned pain modulation may be advocated in treating patients with musculoskeletal pain. The effects of lower extremity aerobic exercise and conditioned pain modulation on evoked shoulder pain are not known.

Purpose: To determine the acute effects of lower extremity aerobic exercise and conditioned pain modulation on outcomes of evoked shoulder pain from pain pressure threshold measurements.

Study Design: Repeated measures.

Methods: Thirty (30) healthy volunteers were tested over the course of two sessions. Session 1 consisted of collecting pain pressure threshold measurements over the infraspinatus before and immediately following a conditioned pain …

Discharge Readiness For Families With A Premature Infant Living In Appalachia, Kathy Zimmerman

Electronic Theses and Dissertations

With increased advances in technology, the overall survival rates in the Neonatal Intensive Care Unit (NICU) for premature infants at lower gestational ages, has also increased. Although premature infants survive at lower gestational ages, they are often discharged to home with unresolved medical issues. While the birth of a new baby for parents is a joyous occasion, they often have difficulty coping and transitioning into a parental role. Premature infants also have ongoing complications such as difficulty with feeding, developmental delays in growth, and long-term eye and respiratory complications. As a result of chronic health sequelae, premature infants require extensive …

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 …

Approachability Of Nursing Clinical Instructors: Psychometric Assessment Of A Scale Development, Angela Collier

Electronic Theses and Dissertations

Approachability of nursing clinical instructors is largely unknown and misunderstood, yet critical for millennial students which currently comprise 82% of nursing students (National League for Nursing, 2014). Nursing education consists of both a didactic and a clinical component. Clinical education is dynamic and allows the student an experiential learning opportunity. Therefore, clinical nursing educators are vitally important. Approachability has been identified in many studies as a leading characteristic of an effective instructor. Although the importance of approachability of the instructor is established, currently no scale exists to measure this concept. The purpose of this study was to examine the validity …

The Effect Of Periodized Strength Training And Periodized Concurrent Training On Running Performance, Nicholas Fiolo

Electronic Theses and Dissertations

The objective of this dissertation was to evaluate the changes in preparedness over the course of training for a marathon in two well-trained runners. The athletes completed periodized strength training or a periodized concurrent training. This dissertation consisted of two separate investigations:

Study 1 – The purpose of this study was to monitor changes in force production ability and running performance in one sub-elite marathon runner before, during, and after undertaking a short-term block periodized strength training program. The athlete ceased strength training during the off-seasons and resumed testing after 10. The athlete experienced likely true, meaningful changes in force …

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 …

Testing Vert™ Accelerometer To Identify Validity And Reliability When Compared To Switch Mat, Tara Mcdonald

Undergraduate Honors Theses

This present study was intended to identify the reliability and validity of the Vert™ device when compared to a Switch mat. Vert is a wireless device intended to measure jump count and jump height through an application on a smartphone or tablet and the Switch mat provides jump height using wireless sensors. Jump height is an important factor in many sports such as volleyball and basketball and it is important to have devices that coaches and trainers can use for testing that they can rely on. If this device is found to be valid and reliable, coaches and trainers …

An Exploration Of Dementia Friendly Communities From The Perspective Of Persons Living With Dementia, Catherine Hebert

Electronic Theses and Dissertations

The growing global prevalence of dementia coupled with a shift in public perception from a hopeless disease to the possibility of living well with dementia has led to the formation of dementia friendly communities (DFC). DFCs are a new phenomenon in the United States, with a gap in knowledge on input from people living with dementia (PLWD). This study investigated DFCs from the perspective of PLWD in Western North Carolina, with the following research questions:

1. How are interactions and relationships experienced by persons living with dementia in the community?
2. How is community engagement experienced by PLWD?
3. To what extent and …

Role Of Cannabinoid Receptor Type 2 (Cb2) In Late Stage Atherosclerosis, Makenzie Fulmer

Electronic Theses and Dissertations

Atherosclerosis is a chronic inflammatory disorder of medium and large vessels. Immune signaling and dyslipidemia are two of several processes which influence lesion development in atherosclerosis. Cannabinoids, such as those found in marijuana, exert their effects through two cannabinoid receptors, CB1 and CB2. Recent studies using CB2 knockout mice and CB2-selective ligands have shed light on a protective role of CB2 in early stages of atherosclerosis. However, the role of CB2 in advanced stages of atherosclerosis remains unclear. To determine if CB2 plays a role in advanced atherosclerotic lesion composition and progression, we investigated the effects of systemic CB2 gene …

The Bobsled Push Start: Influence On Race Outcome And Push Athlete Talent Identification And Monitoring, Alex Harrison

Electronic Theses and Dissertations

Bobsled is an Olympic sport that has progressed from rudimentary in the 1800’s to highly technological replete with biomechanical analyses and investment in engineering from the world’s top engineers. Little to no investigation has been carried out on all the tracks and the interrelationship between various measures of starts and sled-travel down-track. Further, little quality research has been produced in the athletic characteristics required for high-level competition in bobsled.

The present manuscript investigates the reliability of, and interrelationship between, start time, start velocity, split times, and finish times in World Cup 2- and 4-man bobsled competition. A strong relationship between …

Design And Validation Of A Scale For Preschoolers: Measuring Nutrition Knowledge, Beliefs, And Behaviors, Michelle E. Johnson

Electronic Theses and Dissertations

The literature indicates a lack of validated scales to measure nutrition knowledge, attitudes and behaviors in preschool-aged children. Reliable and valid assessment tools are critical in the development of nutritional interventions for young children; careful design, including psychometric evaluation of reliability and validity, is the best approach to scale development. Best practice points to an efficient, yet comprehensive look at the constructs of knowledge, attitudes, and behaviors. This multi-phase study included 298 preschool children ages 2-6 years (151 girls, 147 boys; mean age 3.936). A 45-item scale was created, with 4 subscales to measure the nutrition knowledge, attitudes, and behaviors …

Pre-Licensure Nursing Students’ Perceptions Of Safety Culture In Schools Of Nursing, Kristen Hershey

Electronic Theses and Dissertations

Safety culture has been demonstrated to be a key factor in high-reliability organizations (HROs), yet healthcare has not achieved a safety culture as seen in HROs despite decades of effort. Student nurses are enculturated into their profession during their pre-licensure education. This period offers an excellent opportunity to teach students the values, norms, and practices of safety culture. However, little is known about the state of safety culture in schools of nursing.

The purpose of this study was to examine the state of patient safety culture as perceived by students in pre-licensure nursing programs in the US using a modified …

Outcomes Of An Integrated Approach To Speed And Strength Training With An Elite-Level Sprinter, Eric D. Magrum

Electronic Theses and Dissertations

The purpose of this study was to observe changes in sprint velocity, ground contact time, and peak force demonstrated by a competitive sprinter following an integrated approach to speed development and strength training. As part of an ongoing monitoring procedure the participant completed 20m sprint testing through an optical measurement system and isometric-strength testing before and after each phase of training. Sprint velocity, ground contact time and peak force were analysed using Tau-U, smallest worthwhile and percent change statistics. Results indicate sprinting velocity statistically improved while changes in peak force were practically significant and ground contact time remained trivial throughout …

A Novel Method For Synthesis Of Hydroxytyrosol, Emmanuel Onobun

Electronic Theses and Dissertations

Hydroxytyrosol, 3,4-dihydroxyphenolethanol, a naturally occurring polyphenol most common in olive tree (Olea europaea), is one of the most effective member of the polyphenols family, because of its remarkable antioxidant activity, its ability to inhibit oxidation of low density lipids (LDL), and its protection against DNA oxidative damage. Hydroxytyrosol, which is widely used in cosmetics and food supplements industries, can be purchased as an olive oil extract that contains low concentration of hydroxytyrosol besides other polyphenols. The price and low natural abundance of hydroxytyrosol make alternative synthetic sources very attractive. In this research, a novel method for the synthesis of pure …

Evaluating Effective Communication Methods: Improving Internal Communication, Amber L. Suthers

Electronic Theses and Dissertations

Relaying information from a Chief Communications Officer (CIO), or centralized communications departments to hospital employees is not always efficient or effective. Employees may not be informed of important changes to department protocols or hospital policies. The purpose of the study was to determine the most efficient and effective forms of internal communications in the hospital setting.

A total of 83 surveys were mailed to communication officers working in Tennessee hospitals in and east of Nashville. Sixteen communication officers responded. This low response rate may be attributed to poor designation of communication responsibilities and an abdication of responsibilities to an off …

Effects Of Lactobacillus Rhamnosus Mrs6an On Intestinal Gpat3 Pathway Involved In The Lipid Transport In Enterocytes, Ayodeji Oludare Ipinmoroti

Electronic Theses and Dissertations

Accumulation of triglyceride (TG) in enterocytes of the small intestine follows two specific absorption pathways: the monoacylglycerol acyltransferase pathway (MGAT) and glycerol acyltransferase pathway (GPAT), the latter (GPAT) is usually found in the small intestine. In this study, we investigated the effects of Lactobacillus rhamnosus MRS6AN, an isolate from “amabere amaruranu” a Kenyan traditional cultured milk, on triglyceride accumulation and expression of GPAT3, I-FABP, MTP and NPC1L1 in Caco-2 cell enterocyte model. Intracellular triglyceride level (TG) of Caco2 cells was significantly reduced by live L. rhamnosus (LB) compared with other bacterial products. MTP expression in Caco2 cells was minimally reduced …

An Examination Of The Workloads And The Effectiveness Of An Athlete Monitoring Program In Ncaa Division I Men's Soccer, Matthew L. Sams

Electronic Theses and Dissertations

The purposes of this dissertation were to examine common athlete training and monitoring practices in men’s collegiate soccer and to report the programming strategies and monitoring outcomes for an NCAA Division I men’s collegiate soccer team whose coaching and sport science staff collaborated on a daily basis. The following are the major findings of the dissertation:

Study 1 – Coaches from all divisions of play responded to a custom survey. A majority of coaches developed an in-season training plan that varied both daily and weekly volume and intensity. One-third of the coaches performed no athlete monitoring, and a number of …

Effects Of Acute Sepsis On Renal Structure And Sympathetic Innervation In Mice, Tuqa Alkhateeb

Electronic Theses and Dissertations

Sympathetic nerves are important for renal physiology and sepsis pathophysiology. A recent study showed sprouting of sympathetic nerves in spleen of septic mice. This study was done to test if renal sprouting of sympathetic nerves also happens and to investigate renal morphology in septic mice. Cecal ligation and puncture (CLP) was used to induce sepsis and kidneys were removed for evaluation. Bowman’s space was diminished with cortical bubble cells present suggestive of acute renal pathology, however, renal function was unchanged. Acute sepsis did not affect either renal sympathetic innervation or non-neuronal cholinergic cells. Mouse kidneys had more epinephrine (EPI) than …

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, …

Role Of Tlrs, Hippo-Yap1 Signaling, And Micrornas In Cardiac Repair And Regeneration Of Damaged Myocardium During Ischemic Injury, Xiaohui Wang

Electronic Theses and Dissertations

Cardiovascular disease is a leading cause of death in the United States. Toll-like receptor (TLR)-mediated pathways have been demonstrated to play a role in myocardial ischemia/reperfusion (I/R) injury. We and others have shown that PI3K/Akt signaling is involved in regulating cellular survival and protecting the myocardium from I/R induced injury. In this dissertation, we provide compelling evidence that miR-125b serves to “fine tune” TLR mediated NF-kB responses by repressing TNF-a and TRAF6 expression. We constructed lentiviral expressing miR-125b, delivered it into the myocardium. The data showed that delivery of lentivirus expressing miR-125b significantly reduces myocardial infarct size and improves cardiac …

Difference In Quality Of Life Between Group And Individual Exercise In A Faith-Based Sample, Everett Jackson Amburn

Electronic Theses and Dissertations

There is limited data on the quality of life of individuals who exercise in a group versus individuals who exercise alone. The purpose of this study was to determine if there is a difference in the quality life between adults who attend an exercise class and those who exercise alone. Using the WHOQOL-BREF, 27 adult females were surveyed in Central California at two Church of Latter Day Saints locations. Ten females were enrolled in a group exercise class while 17 were individual exercisers. The data was analyzed using a t-test for independent samples to determine if there is a …

Technical And Physical Match Demands Of A Ncaa Division I Soccer Goalkeeper, Joanne Spalding

Electronic Theses and Dissertations

The purpose of this study was to provide a better understanding of the goalkeeper position in order to prepare goalkeepers for competition. The objectives of this study were to characterize the technical and physical demands of an NCAA Division I collegiate goalkeeper over three seasons and examine trends from season to season. Count and frequency for each definition were analyzed. Results show that although the goalkeeper’s technical demands were characterized by engaging in play without action and being in the goal area, the gradually increased use of the feet over three season’s hints on the importance of skills performed with …

Coping Strategies Of Prelicensure Registered Nursing Students Experiencing Student-To-Student Incivility, Robin A. Foreman

Electronic Theses and Dissertations

Incivility is rude or discourteous behavior that demonstrates a lack of respect for others. Some nurses ignore the dictates of professionalism and exhibit a total disregard for colleagues and peers by purposefully targeting each other with uncivil behaviors. Incivility has invaded the nursing educational environment with deleterious results. Uncivil behaviors perpetrated by nursing students against other nursing students cause psychological and physiological distress for victims and witnesses. The purposes of this quantitative descriptive study were to identify the behaviors that constituted lateral student-to-student incivility, determine the frequency of experienced student-to-student incivility, and describe the coping strategies employed by prelicensure registered …

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 …

Perceptions Of Male Nursing Students About Working In Women’S Health, Jose Mari Lawrence Mitra

Undergraduate Honors Theses

This study explores the opinions and experiences of East Tennessee State University (ETSU) male nursing students after they have completed their clinical rotations in obstetrics (OB). Participants are interviewed about their preconceptions and post-experience perspectives regarding the clinical rotation. After analyzing the interviews, the students’ perceptions appeared to be grounded in their perceived level of comfort with women’s health nursing. Themes include (1) preconceptions, (2) welcoming, (3) rejecting, and (4) culture.

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 …

Nutrient Content Of Human Breast Milk From Overweight And Normal Weight Caucasian Women Of Northeast Tennessee, Megan R. Kwon

Electronic Theses and Dissertations

Many factors influence the nutrient composition of breast milk (BRM) particularly within the fatty acids composition. In this study BRM between 2-14 weeks of lactation was collected from 44 Caucasian women (24 normal weight (NW, BMI 18.5-24.9kg/m²) and 20 overweight (OW, BMI >25.0kg/m²). BRM was subjected to proximate analysis and participants completed food frequency questionnaires (FFQ) to estimate fruit, vegetable, and fat intake. BMI differed between NW and OW groups, 22.03 vs 33.86kg/m² (p0.10) were identified for total calories (5,581.8 vs 5562.9cal/g), %fat (39.6 vs 43.9), or %protein (9.8 vs 8.9) for BRM in NW …