Medicine and Health Sciences Commons^™

Polishing Treadmills At Midnight: Is Refugee Integration An Elusive Goal?, Woods Nash

Catalyst: A Social Justice Forum

It is often said that justice requires us to treat like cases alike. Accordingly, the U.S. refugee resettlement program provides all refugees—no matter where they are from, no matter their pasts—with very similar funding and services. Refugees, however, are far from alike. In this essay, I invoke Borgmann’s distinction between a “thing” and a “device” and draw on stories from my work with a resettlement agency to argue that our current, employment-driven system is in need of reform. Instead of being restricted to generic programs, refugee resettlement agencies should be funded to help each family achieve social integration in ways …

Toward Personalized Medicine: The Potential Role Of Rna Interference In Plasma Cell Dyscrasia, Jonathan E Phipps

Doctoral Dissertations

A major contributor to mortality in patients with plasma cell dyscrasias (PCDs); i.e., multiple myeloma, light chain deposition disease and AL amyloidosis is the deposition as insoluble aggregates of monoclonal immunoglobulin light chain proteins (LC) in the kidneys and other organs. Currently anti-plasma cell chemotherapies are used to reduce LC synthesis, and slow deposition. While effective, these treatments are toxic, non-specific, expensive, and might not be appropriate in all cases, making the identification of an alternate means of reducing toxic LC species desirable. To this end, we have investigated whether RNA interference (RNAi) could achieve these goals.

Human (RPMI 8226, …

Prenatal Care Choices In Appalachia: A Qualitative, Critical Realist Description & Content Analysis, Julia Cain Phillippi

Doctoral Dissertations

Introduction: Appalachian women have high rates of preterm birth and low birth weight infants. A new format of group prenatal care, known as CenteringPregnancy, decreases the rate of preterm birth and low birth weight when compared with individual care. However, clinics in Appalachia often struggle to recruit women into group care. Theory & Methods: Using critical realism and the middle-range theory of motivation-ease as frameworks, this qualitative study had two research questions: ‘What influences Appalachian women’s choice of traditional prenatal care instead of CenteringPregnancy care?’ and ‘What are Appalachian women’s perceptions of prenatal care and their access to prenatal care?’. …

Characterization Of A Small Animal Spect Platform For Use In Preclinical Translational Research, Dustin Ryan Osborne

Doctoral Dissertations

Imaging Iodine-125 requires an increased focus on developing an understanding of how fundamental processes used by imaging systems work to provide quantitative output for the imaging system. Isotopes like I-125 pose specific imaging problems that are a result of low energy emissions as well as how closely spaced those emissions are in the spectrum. This work seeks to characterize the performance of a small animal SPECT-CT imaging system with respect to imaging I-125 for use in a preclinical translational research environment and to understand how the performance of this system relates to critical applications such as attenuation and scatter correction. …

Geographic Disparities Associated With Stroke And Myocardial Infarction In East Tennessee, Ashley Pedigo Golden

Doctoral Dissertations

Stroke and myocardial infarction (MI) are serious conditions whose burdens vary by socio-demographic and geographic factors. Although several studies have investigated and identified disparities in burdens of these conditions at the county and state levels, little is known regarding their geographic epidemiology at the neighborhood level. Both conditions require emergency treatments and therefore timely geographic accessibility to appropriate care is critical. Investigation of disparities in geographic accessibility to stroke and MI care and the role of Emergency Medical Services (EMS) in reducing treatment delays are vital in improving health outcomes. Therefore, the objectives of this work were to: (i) classify …

“This Is Me. I Like Who I Am”: A Qualitative Descriptive Study Using Photo Elicitation To Examine The World Of The School-­Age Child With Cystic Fibrosis, Renee Carol Burk

Doctoral Dissertations

School-age children with Cystic Fibrosis (CF) possess valuable knowledge about themselves. They have experience and ability to offer insight about living with CF. Previous studies, exploring the perceptions of CF children, give little attention to eliciting and listening to their voices. Also, traditional data collection methods limit children from participating in research. The purpose of this study was to explore and describe how school-age children with CF see themselves in the world they live.

The study utilized qualitative description methodology. Symbolic Interactionism served as the researcher’s philosophical lens. It is a perspective that seeks to understand the social world of …

The Role Of Systemic Inflammation In The Development Of Equine Laminitis, Elizabeth Maryrose Tadros

Doctoral Dissertations

Laminitis is a crippling disease of horses that can result in chronic lameness and debilitation, and sometimes warrants euthanasia. It is a complication of inflammatory conditions such as gastrointestinal disease, and also occurs in obese, insulin-resistant horses with Equine Metabolic Syndrome (EMS). Inflammation and insulin resistance are risk factors for laminitis, and these mechanisms might converge to induce laminitis in susceptible animals.

Systemic inflammation is often attributed to endotoxemia, although circulating endotoxin concentrations are not commonly measured in the clinical setting. Although a theoretic basis exists for endotoxemia in the pathogenesis of laminitis, administration of endotoxin alone does …

Identification Of Novel Molecular Targets Of Resveratrol In Colorectal Carcinogenesis, Nichelle Chantil Whitlock

Doctoral Dissertations

Current research suggests resveratrol, a phytoalexin found predominately in grapes, may function as a chemopreventive and/or chemotherapeutic agent for various cancers, including colorectal cancer. However, the underlying mechanism(s) involved in these activities remain elusive. Thus, the objective of the studies discussed here sought to investigate the effect of resveratrol treatment on gene modulation in human colorectal cancer cells in order to identify and characterize novel molecular targets that contribute to the observed anticancer activities of resveratrol. Here, we identify activating transcription factor 3 (ATF3) and early growth response-1 (Egr-1) as novel targets of resveratrol and provide data to elucidate the …

Asymmetric Total Synthesis Of Congeners Of Hydramycin, An Anthraquinone-Type Antitumor Agent, Costyl Ngnouomeuchi Njiojob

Doctoral Dissertations

Hydramycin is an antitumor antibiotic isolated from Streptomyces violaceus. It is a pyranoanthraquinone-type antitumor agent that has shown broad-spectrum activity against a variety of human-derived cancer cell lines. Among tumors evaluated at the National Cancer Institute (lung, colon, melanoma, breast and prostate), GI₅₀s were <10⁻¹⁰ M in the NCI's 60-cell-line panel. We embarked on the synthesis and evaluation of a simplified congener 2-(1-hydroxy-1-(oxiran-2-yl)ethyl)-4H-naphtho[2,3-h]chromene-4,7,12-trione(17), which would facilitate synthesis while retaining the potent activity. Hydramycin has two chiral centers, and our goal is to design and synthesize all the possible enantiomers (four in …

Spatial Epidemiology And Temporal Trends Of Heart Attack And Stroke In Middle Tennessee, Doreen Busingye

Masters Theses

Despite declines in mortality risks of myocardial infarction (MI) and stroke in the US since the 1960’s, the burdens of these conditions remain high. These conditions require emergency and specialized care and therefore quick transportation of patients to appropriate hospitals is critical. Geographic disparities in MI and stroke burdens have been consistently reported in the US with the south-east having the highest risks. Most studies of geographic disparities have been performed at county or higher geographic units. Therefore, spatial patterns at neighborhood levels are unclear. Moreover, it’s important to investigate disparities at neighborhood levels to better understand neighborhood health needs. …

#Trending Now: Why Black Folk Need To Be In Psychotherapy, Samantha Lynn Gray

Black Issues Conference

Despite evidence that mental health problems (ranging from very mild to severe) affect all people, the rates of minorities engaged in personal psychotherapy have remained low throughout the past few decades. Historically, minorities have tended to devalue the importance of mental health, and stigmatize therapeutic interventions. This session will focus on why we need to shed the stigma surrounding mental health issues, and detail where we’ve been, where we are, and where we need to head in term of opening ourselves to self-exploration within the realm of psychotherapy. Also learn about how our physical health is intertwined with our mental …

Heifer Estrous Cycle Stage Impacts Luteinizing And Growth Hormone Response To Kisspeptin, Brian K. Whitlock, Joseph A. Daniel, Robyn R. Wilborn, Barbara P. Steele, James L. Sartin

Animal Science Publications and Other Works

The reproductive neuropeptide, kisspeptin (KP), may have a role in regulation of growth hormone (GH) secretion. Expression of KP and its receptor (Kiss1r) are developmentally and hormonally regulated. This study was conducted to determine the effects of KP on plasma concentrations of luteinizing hormone (LH) and GH in pubertal heifers during different functional reproductive stages. Heifers received a single injection of KP (100 pmole / kg) or saline intravenously during proestrus, estrus, and diestrus, and serial blood samples were collected for 3 hours to determine the response of both LH and GH after treatment. Mean concentrations of LH were increased …

Frontiers (Fall 2011) - Primary Care: The Key To Coordinated Healthcare, University Of Tennessee Medical Center, University Of Tennessee Graduate School Of Medicine

Frontiers Magazine

No abstract provided.

Effect Of Kisspeptin On Regulation Of Growth Hormone, Brian K. Whitlock, Joseph A. Daniel, Robyn R. Wilborn, Herris S. Maxwell, Barbara P. Steele, James L. Sartin

Animal Science Publications and Other Works

Kisspeptin ( KP ), a neuroendocrine regulator of reproduction, is hypothesized to be an integrator of metabolism and hormones critical to the regulation of reproduction. Lactation is associated with enhanced growth hormone (GH) responsiveness and reduced fertility. Our study was designed to determine the effects of lactation on KP-stimulated GH and luteinizing hormone (LH) secretion. Five non-lactating and five lactating dairy cows were used in the study. Experiments were conducted with lactating cows at weeks 1, 5 and 11 after parturition. The experimental treatments ( saline and KP [100 and 400 pmol / kg body weight]) were given intravenously and …

Neighborhood Disparities In Stroke And Myocardial Infarction Mortality: A Gis And Spatial Scan Statistics Approach, Ashley Pedigo, Tim Aldrich, Agricola Odoi

Faculty Publications and Other Works -- UT Graduate School of Medicine

Background

Stroke and myocardial infarction (MI) are serious public health burdens in the US. These burdens vary by geographic location with the highest mortality risks reported in the southeastern US. While these disparities have been investigated at state and county levels, little is known regarding disparities in risk at lower levels of geography, such as neighborhoods. Therefore, the objective of this study was to investigate spatial patterns of stroke and MI mortality risks in the East Tennessee Appalachian Region so as to identify neighborhoods with the highest risks.

Methods

Stroke and MI mortality data for the period 1999-2007, obtained free …

The Effect Of Reflective Writing Interventions On Critical Thinking Skills, Jessica L Naber

Doctoral Dissertations

The importance of critical thinking as an outcome for students graduating from undergraduate nursing programs is well-documented by both the American Association of Colleges of Nursing (AACN) and the National League for Nursing (NLN). Graduating nurses are expected to apply critical thinking in all practice situations to improve patient health outcomes. Reflective writing is one strategy used to increase understanding and ability to reason and analyze. The lack of empirical evidence regarding the effectiveness of reflective writing interventions on increasing critical thinking skills supports the need for examining reflective writing as a critical thinking strategy. The purpose of this study …

Immunologic Risk Prediction Model For Kidney Graft Function, Christina Diane Bishop

Doctoral Dissertations

Clinicians lack appropriate non-invasive methods to be able to predict, diagnose, and reduce the risk of rejection in the years following kidney transplantation. Protocol biopsies and monitoring of serum creatinine levels are the most common methods of monitoring graft function after transplant; however, they have several negative aspects. Use of traditional factors regarding donors and recipients such as Human Leukocyte Antigen (HLA) DNA typing, pre-transplant anti-HLA antibody levels, and basic demographics (age, ethnicity/race, gender), has proved inadequate for post-transplant graft monitoring past the first few years. We propose that by utilizing immunologic factors available to clinicians across the United States, …

Behavioral Activation Of Religious Behaviors: Treating Depressed College Students With A Randomized Controlled Trial, Maria Elizabeth Anne Armento

Doctoral Dissertations

Abstract

Although spiritual or religious behaviors are sometimes targeted within behavioral activation protocols (Hopko & Lejuez, 2007; Hopko, Lejuez, Ruggiero, & Eifert, 2003), the efficacy of a protocol that exclusively develops a religiously-based behavioral repertoire has not been investigated. This randomized controlled study investigated the efficacy of a brief protocol for religious action in behavioral activation (PRA-BA) relative to a no-treatment “support” condition among mild to moderately depressed undergraduate students (n = 50). PRA-BA consisted of an individualized one-session intervention and 2-week activation interval. Clinical outcomes assessed depression, environmental reward, anxiety, and quality of life. Repeated measures ANOVAs indicated …

Disaster Education For Nurses: A Comparison Of Two Instructional Methods For Teaching Basic Disaster Life Support In The Light Of Self-Efficacy Theory, Mary Catherine Nypaver

Doctoral Dissertations

Abstract

Nurses constitute the largest group in the healthcare workforce and are called on to assist in emergencies such as disasters. Research has shown that professionals with higher levels of knowledge are more likely to respond to actual emergencies. Yet most hospital based nurses do not possess the skills needed for disaster response. The Basic Disaster Life Support (BDLS) course, with its comprehensive content, represents the gold standard for disaster education. Since confidence also plays a role in response, a tool to measure this variable could be useful. There were five purposes of this study: determine whether one teaching method …

Role Of Il-17 And Th17 Cells In Hsv Induced Ocular Immunopathology, Amol Sahebrao Suryawanshi

Doctoral Dissertations

Herpes simplex virus (HSV) infection of the cornea leads to a blinding immuno-inflammatory condition of the eye also called stromal keratitis (SK). SK immunopathology is characterized by the infiltration of CD4⁺ T cells of Th1 phenotype as well as the development of new blood vessels into the normally avascular cornea. Studies in mouse models of SK have firmly established the role of CD4⁺ T cells, and particularly of Th1 phenotype, as the principal mediators of SK immunopathology. However, with the recent discovery of IL-17A and Th17 cells, the role of this cytokine as well as Th17 cells remains …

Using Sport To Build Community: Service-Learning With Iraqi Refugees, Ashleigh Morgan Huffman

Doctoral Dissertations

The purpose of this study was to explore the connections between Sport for Development and Peace (SDP), service-learning, and community-university partnerships through the implementation of the Service-Learning: Sport and Community Development (SCD) class. It was my hope that this research would produce a usable model, a framework for other scholars and practitioners interested in developing community-university partnerships. I wanted this project to not only answer the “why” questions for SDP and service-learning, but also the “how” questions – specifically, how to create a reflexive and collaborative partnership that balances the needs of the community and university. I wanted to create …

Physical Activity Assessment In Wheelchair Users, Scott Alexander Conger

Doctoral Dissertations

Purpose: To examine the relationship between hand rim propulsion power and energy expenditure during wheelchair locomotion. Methods: Fourteen individuals who used manual wheelchairs were included in this study. Each participant performed five different locomotion activities in a wheelchair with a PowerTap hub built into the rear wheel. The activities included wheeling on a level surface that elicited a low rolling resistance at three different speeds (4.5, 5.5, and 6.5 km∙hr^-1), wheeling on a rubberized 400m track that elicited a higher rolling resistance at one speed (5.5 km∙hr^-1), and wheeling on a sidewalk course that included uphill …

Healing Of The Body, Mind, And Spirit: Addiction, Spirituality, And Alcoholics Anonymous, Ainsley Jillian Pierce

Chancellor’s Honors Program Projects

No abstract provided.

The Effect Of Kisspeptin Receptor Agonist (Ftm080) On Luteinizing Hormone In Sheep, Brian K. Whitlock, Joseph A. Daniel, Maria Hes, Barbara P. Steele, James L. Sartin, S. Oishi, N. Fujii

Animal Science Publications and Other Works

Kisspeptin receptor (Kiss1r) agonists with increased half-life and similar efficacy to kisspeptin (KP) in vitro potentially may provide beneficial applications in breeding management of many species. However, many of these agonists have not been tested in vivo. This study was designed to test the effect of a Kiss1r agonist (FTM080) on luteinizing hormone (LH) in vivo. Sheep were treated with FTM080 (500 pmol/kg BW) or sterile water in a 2-ml bolus via the jugular cannula. Serial blood samples were collected every 15-min before (1 hr) and after (1 hr) treatment. Intravenous (IV) injection of FTM080 increased (P < 0.05) LH plasma concentrations through the 45-min sample following treatment. Moreover, the area under the curve of LH in the period from 0 to 60-min following FTM080 treatment was also increased (P < 0.05). These data provide evidence to suggest that FTM080 stimulates the gonadotropic axis of ruminants in vivo.

A Geospatial Based Decision Framework For Extending Marssim Regulatory Principles Into The Subsurface, Robert Nathan Stewart

Doctoral Dissertations

The Multi-Agency Radiological Site Survey Investigation Manual (MARSSIM) is a regulatory guidance document regarding compliance evaluation of radiologically contaminated soils and buildings (USNRC, 2000). Compliance is determined by comparing radiological measurements to established limits using a combination of hypothesis testing and scanning measurements. Scanning allows investigators to identify localized pockets of contamination missed during sampling and allows investigators to assess radiological exposure at different spatial scales. Scale is important in radiological dose assessment as regulatory limits can vary with the size of the contaminated area and sites are often evaluated at more than one scale (USNRC, 2000). Unfortunately, scanning is …

The Association Of Genotype, And The Gene-Physical Activity Interaction Effect On Aerobic Fitness In Prepubertal, African American, Obese Children, Jennifer Irene Flynn

Masters Theses

Purpose: To determine the association of certain aerobic fitness and physical activity genotypes and the gene-physical activity interaction effect on aerobic fitness in pre-pubertal, African American, obese children. Methods: Subjects were 30 pre-pubertal, African American, obese children (9.5 ± 1.7 years) who were free of clinical disease. Height and weight were measured according to standard procedures. Body fat was assessed using dual energy x-ray absorptiometry, and DNA samples were collected using buccal swabs. Aerobic fitness was assessed using a cycle ergometer and the McMaster cycle protocol. ANOVAs were used to determine associations and interaction effects of the ACE, ADRB2, NOS3, …

Stretching With Whole Body Vibration Versus Traditional Static Stretches To Increase Acute Hamstring Range Of Motion, Anastasia Elizabeth Bourne

Masters Theses

PURPOSE The purpose of this study was to determine if performing static active knee extension hamstring stretching using the Pneumex Pro-Vibe vibrating platform increased acute hamstring range of motion (ROM) greater than traditional static active knee extension hamstring stretching. METHODS: A within subject design was utilized with subjects undergoing static stretching with vibration and without vibration (conditions counterbalanced). Pre- and post-test active and passive ROM was measured for the right leg, with subjects first undergoing a 5-minute warm-up on a stationary bicycle. Supine active knee extension was performed on the Pro-Vibe platform with and without vibration. The stretch was held …

“Learning The Hard Way”: An Examination Of Acculturative Support For Latin-American Baseball Players In The South Atlantic League, Lauren Melanie Osmer

Masters Theses

Latin-Americans have become major contributors in Major League Baseball, but face many challenges acculturating to living and playing in the United States. This research examined the acculturative support provided to Latin-American players by teams in the South Atlantic League of Minor League Baseball and whether or not people involved think that support was effective. Semi-structured interviews were conducted with front-office members and Latin-American former players, and transcriptions were analyzed for emerging themes using QDA Miner content analysis software. Three main themes emerged from the interviews: the language barrier, interaction between Latin-American and Anglo-American teammates, and the youth of Latin-American prospects. …

Terminal Sedation, Karen L Smith

Doctoral Dissertations

This dissertation will support full ethical endorsement of terminal sedation for those most urgently in crisis and need of beneficence, those who are dying and in the final hours or days and suffering. To clarify the practice I first detail ethical differences between euthanasia, physician assisted suicide and terminal sedation. Moreover, I identify new areas where harms and benefits need to be evaluated as affecting not only patients, but also families and caregivers. I evaluate the current practice to allow the development of ethical guidelines and greater consensus on deciding the hard cases. This work may also serve to assist …

Frontiers (Summer 2011) - Special Insert: The Impact Of Education, Research And Patient Care, University Of Tennessee Medical Center, University Of Tennessee Graduate School Of Medicine

Frontiers Magazine

No abstract provided.