Medicine and Health Sciences Commons^™

Reducing Copd Readmissions Through The Implementation Of A Guideline-Based Clinical Pathway: An Evidence-Based Practice Improvement Project, Hannah F. Hall, Allyson Neal, Samantha Bauer

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

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. It is characterized by airway inflammation and damage that inhibits appropriate airflow. Exacerbations of COPD (ECOPD) hasten disease progression and have profound impacts on the patients.

Local Problem: East Tennesseans experience higher rates of COPD than the rest of the state. Community members at the project site identified that the inpatient management of ECOPD is inconsistent and discordant with the 2023 Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. The purpose of this project was to reduce readmissions and increase guideline concordance by developing an algorithm …

Black Bear Population Health Monitoring In The Southeast, Kathleen Elizabeth Riese

Masters Theses

Recent growth of the American black bear (Ursus americanus) population in the southeast raises concerns about the potential spread of density-dependent diseases among bears, particularly sarcoptic mange. However, research on the health of bears in this area is limited. We analyzed samples from 169 bears in the region. We performed Knotts tests, skin scrapes, fecal floats; Canine adenovirus (CAV), canine parvovirus (CPV), canine distemper virus (CDV), and Toxoplasma gondii serology, Trypanosoma, Rickettsia rickettsii, and apicomplexan PCR, and identified ecto- and endoparasites found grossly or histologically. We found that 69% (63 of 91) had microfilaria; genetic analysis identified …

Implementation Of An Evidence-Based Diabetic Screening Tool In Rural Belizean Communities, Morgan Lee Taylor, Annelyse Caffrey

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

Significance/Background: Type II Diabetes Mellitus (TIIDM) is a growing epidemic in Belize. The prevalence is increasing yearly, responsible for considerable health complications and deaths. Rates are much higher in Belize than in any other developing Central American country, and many rural citizens are undiagnosed and untreated. Access to healthcare is complex, and travel is often required in rural areas. Primary care visits in Belize are significantly less than in surrounding North and Central American countries. As a result, chronic illnesses such as TIIDM often go undiagnosed among children, adolescents, and adults- leaving TIIDM a leading cause of death in Belize. …

Leptospira Seroprevalence In Companion Animals In Tennessee, Kellie Anne Mccreight

Masters Theses

Leptospirosis is a re-emerging zoonotic disease in humans and animals. The bacteria Leptospira spp. causing this disease is maintained in the kidneys of animals such as rodents and cattle as well as in the environment. Animals harboring Leptospira spp. in the kidneys frequently shed the bacteria in their urine, contaminating the environment. Contact with contaminated soil and water may result in infection. Animals and humans may develop serious life threatening disease from Leptospira infection. Approximately 1 million new human cases and over 50,000 deaths are reported worldwide. Numerous animal species including rodents, cattle, and dogs may serve as reservoir …

Educating School Nurses To Improve Bowel Continence In Children With Spina Bifida, Mckinley J. Waugh, Tracy L. Brewer, Lisa Wagoner

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

Children born with spina bifida, a neural tube defect, can have associated loss of bowel control resulting in bowel incontinence. The National Patient Spina Bifida Registry found that 87% of those living with spina bifida had bowel incontinence, and less than 30% were bowel continent (Sawin et al., 2015; Wiener et al., 2017). Unfortunately, providers may never start a child living with spina bifida on a bowel management program. Evidence suggests that children with spina bifida should begin a bowel management program early, using a stepwise approach. School nurses, who interact with children living with spinal bifida while attending school, …

Implantable Medical Devices For Local Drug Delivery And Tissue Regeneration To Combat Chronic Bacterial Infection, Caroline J. Billings

Doctoral Dissertations

Local drug delivery has been an area of exceptional interest in the treatment of chronic bacterial infections, particularly in areas where there are medical implants placed. Medical implants are widely utilized and are becoming increasingly popular with time. With the increasing use of medical implants, concomitant bacterial infection is also increasing, and this type of bacterial infection can be exceedingly difficult to clear. The following body of work focuses on implant-associated bacterial infection, with an emphasis on chronic Staphylococcus aureus (S. aureus) infection, particularly osteomyelitis. Specifically, this work is focused within the scope of utilizing locally implantable medical …

Role Of Temperature, Transmission Pathways, And Pathogen Load In Batrachochytrium Salamandrivorans Epidemiology, Edward Davis Carter

Doctoral Dissertations

Amphibian populations are experiencing dramatic population declines. Amphibian diseases are one of the major reasons for these declines. A newly described fungal pathogen, Batrachochytrium salamandrivorans (Bsal), has been recently introduced to Europe and is currently decimating European salamander populations. Sampling efforts have not detected Bsal yet in the United States in captive or wild populations. Disease management hinges on knowing how environmental, host, and pathogen interactions influence disease occurrence and severity. Understanding routes of pathogen transmission is also critical as knowledge of these routes can elucidate management strategies. In Chapter I of my dissertation, I measured how environmental …

Cat Covid, Cmv And Chemokines, Oh My!, Trevor Hancock

Doctoral Dissertations

Cytomegalovirus (CMV) is an important pathogen infecting most humans worldwide. CMV infection within immunocompromised individuals can cause severe morbidity and potential mortality. Disease during CMV infection is due to virus dissemination and subsequent inflammation. Host immune cells lie at the intersection potentially mediating both. The CMV-encoded viral chemokine vCXCL-1 is a proposed virulence factor in mouse models increasing immune cell recruitment and disease. However, the primary immune cell mediator is undetermined. To identify targets, Chapter 2 examines CXCR2 expression (receptor for vCXCL-1) among various mouse tissues and human peripheral blood under steady-state conditions. In vitro, isoforms of HCMV’s vCXCL-1 …

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 …

Unraveling The Molecular Foundations Behind The Diverged Behaviors Of Mouse Insulin 1 And Insulin 2, Connecting Diabetes Risk With Glucocorticoid Treatment And Chronic Migraine Through The Analysis Of Islet Chemistry, And Capturing Key Posttranslational Modifications All Through The Application Of A Novel Lc-Ims-Ms Workflow, Connor Christopher Long

Select or Award-Winning Individual Scholarship

We display the capabilities of our established liquid chromatography-ion mobility spectrometry-mass spectrometry (LC-IMS-MS) workflow in the investigations of islet chemistry at the sub-single-islet level. We begin by characterizing the structural differences of Ins1 and Ins2 to present novel insights as to why their behaviors diverge. We then examine the effects of the stress hormone corticosterone, the rodent equivalent of human cortisol that is often used as a therapeutic, on pancreatic peptide hormone secretion. We also uncover the molecular connection behind the inverse relationship between type 2 diabetes (T2D) risk and chronic migraine via the neuropeptides CGRP and PACAP. Lastly, we …

Locked Nucleic Acid Aptamer And 10 Nm Gold Nanoparticles Increases The Sensitivity Of A Prion Protein Detection Assay, Haley Channell

Chancellor’s Honors Program Projects

No abstract provided.

An Epidemiologic Study Of Vaccination Exemptions And Pertussis Risk, Corinne B. Tandy

Doctoral Dissertations

The incidence of pertussis, a vaccine-preventable disease that can have severe complications in infants, has been increasing in the United States over the past three decades. Vaccine hesitancy and refusal have also increased and are associated with vaccination exemptions, which in turn are associated with outbreaks of vaccine-preventable diseases, including pertussis. Understanding attitudes towards vaccinations and identifying geographic disparities of vaccination exemptions and pertussis risks is useful for guiding control programs. Therefore, the objectives of this study were to: (i) investigate attitudes towards vaccinations; (ii) identify county-level geographic disparities and sociodemographic predictors of vaccination exemptions in Florida; (iii) investigate county-level …

Anti-Inflammatory And Chemopreventive Activity Of Lunasin From Tofu Whey For The Management Of Gastrointestinal Diseases, Cindy Andrea Nieto Veloza

Doctoral Dissertations

Gastrointestinal diseases such as inflammatory bowel diseases (IBD) and colorectal cancer (CRC) are pathological conditions associated with chronic inflammation, characterized by intestinal damage, debilitating symptoms, and detrimental health consequences. The increased risk of CRC in IBD patients, and the adverse effects associated with current therapeutic strategies, point out the need for safer alternatives to reduce chronic inflammation in the bowel. Lunasin is a bioactive peptide naturally occurring in soybeans, with chemopreventive and anti-inflammatory properties demonstrated in several extra-intestinal diseases. However, to date, there is no evidence of the biological activity of lunasin on the gastrointestinal tract as a target site. …

Psychedelics Can Save: The Scientific And Social Case For Rescheduling Psychedelic Compounds, Galen M. Fader

Chancellor’s Honors Program Projects

No abstract provided.

Dna Damage And Aging In Progeria Compared To Healthy Cells., Ashtyn Marie Hill

Chancellor’s Honors Program Projects

No abstract provided.

Prevalence Of Rats And Rodent Borne Pathogens Across Post-Katrina New Orleans, Bruno Marco Ghersi

Doctoral Dissertations

Disasters are happening at an increasingly higher rate and intensity a trend that is expected to continue as more humans migrate to coastal urban areas. Disasters, and as importantly, disaster recovery can affect how native and pest populations will recover. My aim was to improve understanding of disease risk by evaluating the socioecological conditions that have shaped commensal rat recovery and distribution, as well as the pathogens they carry, across New Orleans after Hurricane Katrina. I first estimated relative abundance and distribution of commensal rats from rodent trapping conducted between mid-2014 and early-2017 across 96 sites in 10 areas of …

Applying Modern Immunology To The Plague Of Ancient Athens, Juhi C. Patel

Pursuit - The Journal of Undergraduate Research at The University of Tennessee

During the 5^th century BCE, ancient Athens and Sparta were involved in a major war during which an epidemic disease broke out in Athens, claiming the lives of a substantial part of the population. Although the ancient Greek historian Thucydides provides a first-hand account of the symptoms of the plague, modern historians have not been able to definitively identify the pathogen that caused the deadly epidemic. In 1994, a burial tomb of Athens was unearthed that unveiled the likely remains of plague victims. In 2005, scientists conducted molecular testing on the dental remains and used suicide PCR to compare …

The Current Neuroscientific Understanding Of Alzheimer's Disease, Rachel A. Brandes

Pursuit - The Journal of Undergraduate Research at The University of Tennessee

Alzheimer’s disease is a degenerative neurological illness characterized by the deterioration of brain regions implicated in memory and cognitive function. While researchers have yet to find a cure or effective treatment, they have gained a better understanding of its pathology and development. Through years of neuroscience research, scientists have discovered much of what happens in the brain during Alzheimer’s disease onset and how this causes its symptoms; many hypotheses regarding this aspect of the illness involve temporal lobe atrophy, neurofibrillary tangles, and amyloid plaques. Although Alzheimer’s disease affects millions of people every day, it seems that most are unaware of …

Sleep And Circadian Rhythm Dysfunction In Alzheimer’S Disease, Sarah G Bridgeman

Chancellor’s Honors Program Projects

No abstract provided.

Identifying Cystic Fibrosis (Cf) Skeletally: A Proposed Differential Diagnosis, Clare Remy

EURēCA: Exhibition of Undergraduate Research and Creative Achievement

Cystic fibrosis (CF) is an inherited disorder that affects the mucosal lining of the lungs and digestive system due to a defective gene that causes blockages of tubes, ducts, and passageways. The type of mutation correlates with the severity of the condition, but with modern medicine individuals can live into their 50s. We propose a differential diagnosis for identifying CF in the skeleton based on bony pathologies that occur in higher frequency in CF patients. CF patients exhibit chronic sinusitis, clubbing of hands and feet, vertebral fractures/collapse and abnormal curvature, significantly shorter stature, lower bone density, rib fractures, and an …

Geographic Distribution Of Staphylococcus Spp. Infections And Antimicrobial Resistance Among Dogs From Gauteng Province Presented At A Veterinary Teaching Hospital In South Africa., Daniel Nenene Qekwana, James Wabwire Oguttu, Agricola Odoi

Faculty Publications and Other Works -- Biomedical and Diagnostic Sciences

The objective of this study was to investigate spatial patterns of staphylococcal infections and resistance patterns of clinical isolates from dogs from Gauteng province in South Africa. Data from records of 1,497 dog clinical samples submitted to a veterinary teaching hospital between 2007 and 2012 were used in the study. Spatial empirical Bayesian smoothed risk maps were used to investigate spatial patterns of staphylococcal infections, antimicrobial resistance (AMR), and multidrug resistance (MDR). Moran’s I and spatial scan statistics were used to investigate spatial clusters at municipal and town spatial scales. Significant clusters of staphylococcal infections were identified at both the …

Pkm2 Influences The Metabolic Fate Of Butyrate In Colorectal Cancer Cells, Megan Louise Pence

Chancellor’s Honors Program Projects

No abstract provided.

The Relationship Between Adult Caregiver Health Literacy And Child Body Mass Index Outcomes In A Childhood Obesity Intervention Program, Natalie Renee Cross

Chancellor’s Honors Program Projects

No abstract provided.

Urine Sodium Concentrations Are Predictive Of Hypoadrenocorticism In Hyponatremic Dogs: A Retrospective Pilot Study, Elizabeth More Lennon, Shelly L. Vaden

Faculty Publications and Other Works -- Small Animal Clinical Sciences

Abstract

OBJECTIVES:

To determine if a urine sodium concentration could be used to rule out hypoadrenocorticism in hyponatraemic dogs.

MATERIALS AND METHODS:

Medical records were reviewed for hyponatraemic dogs (serum sodium/L) that had recorded urine sodium concentrations. Twenty hyponatraemic dogs were included: 11 diagnosed with classical hypoadrenocorticism and nine with non-adrenal causes of hyponatraemia. A Wilcoxon rank-sum test was used to compare results between groups.

RESULTS:

No dog with hypoadrenocorticism had a urine sodium concentration less than 30 mmol/L. Urine sodium concentration in dogs with hypoadrenocorticism was significantly higher (median 103 mmol/L, range: 41 to 225) than in dogs with …

Investigating The Regulation Of Indole-3-Acetic Acid Production By The Plant Associated Microbe Pantoea Sp. Yr343, Kasey Noel Estenson

Doctoral Dissertations

The auxin indole-3-acetic acid (IAA) plays a central role in plant growth and development and many plant-associated microbes produce IAA. Several IAA biosynthetic pathways have been identified in microbes which use the precursor tryptophan. Pantoea sp. YR343, which was isolated from the Populus deltoides rhizosphere, is a robust plant root colonizer that produces IAA. Using genomic and metabolomics analyses, we predicted that the indole-3-pyruvate (IPA) pathway is the major pathway in Pantoea sp. YR343 for IAA production. To better understand IAA biosynthesis and the effects of IAA exposure on cell physiology, we performed proteomics on Pantoea sp. YR343 grown in …

Effect Of Ultrasonication On The Physicochemical Properties Of Sorghum Kafirin And Evaluation Of Its Anti-Inflammatory Properties In Vitro, Andrew Cullen Sullivan

Masters Theses

Sorghum is one of the hardiest, most drought resistent cereal grains known to exist, providing the bulk of nutritional content for many semi-arid regions and developing countries throughout Africa and southwestern Asia. It contains dense nutritional value, but due to inhibition factors within the grain, much of these nutrients are indigestible. Access to these nutrients, which have shown to contain high contents of bioactive molecules linked to the decrease of prevalence of chronic disease, must then be facilitated before consumption. In sorghum, these molecules could include complex carbohydrates, proteins and polyphenols. The overall objective of this study was to determine …

Portrait Of Hiv For The East Region Of Tennessee, Emmitt Lee Turner

Chancellor’s Honors Program Projects

No abstract provided.

The Causative Agents Of Viral Hemorrhagic Fever: Do They Have A Common Ancestor?, Mark B. Schneider

Chancellor’s Honors Program Projects

No abstract provided.

Health Assessment Of Two Reintroduced Populations Of American Martens (Martes Americana) In Michigan, Maria Catherine Spriggs

Doctoral Dissertations

The American marten (Martes americana) was extirpated from Michigan during the early-20th century due to loss of vast areas of mature conifer forest and unregulated trapping. The species was reintroduced into the Upper Peninsula (UP) and Northern Lower Peninsula (NLP) during the mid-20th century. While the American marten population in the UP has grown and is doing well, the population in the NLP has been less successful. The reasons for the limited success of the NLP population are unknown, but may include lack of suitable habitat, limited reproductive success, poor genetic diversity, disease, or negative environmental impacts. American …

Brown And Beige Adipocytes: Effects Of Inflammation And Nutritional Intervention, Jiyoung Bae

Doctoral Dissertations

Recent findings of brown adipocytes and brown-like or beige adipocytes, capable of dissipating energy as heat, in adult humans have promised new hope for obesity treatment and prevention. Understanding of the regulation of brown and beige adipocytes will provide novel strategies to reach the goal. Pattern recognition receptors (PRR) are responsible for inflammation in adipose tissue, which leads to adipose dysfunction and obesity associated chronic diseases. It has been shown that PRR activation induces inflammation, leading to insulin resistance in white adipocytes and white adipose tissue (WAT). However, the roles of PRR activation in brown adipocytes and brown adipose tissue …