Medicine and Health Sciences Commons^™

Investigating The Transfer Of Learning, Psychological, And Neural Effects In Immersive Virtual Reality, Logan Taylor Markwell

Doctoral Dissertations

Achieving mastery or expertise requires a substantial amount of quality practice. Recent technological developments have introduced a novel approach to practice, virtual reality. Specifically, virtual reality offers a low-cost, customizable opportunity to practice while minimizing the risk of the individual. Given that some types of practice may not lead to the acquisition of a motor skill, or worse, lead to detriments of that skill, understanding the developing science of motor behavior in relation to virtual reality is imperative. The following literature review will begin with a brief historical account of the evolution of virtual reality. Next, some terms of virtual …

Spatial Epidemiology Of Prediabetes And Diabetes In Florida, Md Marufuzzaman Khan

Doctoral Dissertations

The burden of diabetes and diabetes-related Emergency Department (ED) visits has increased in Florida. However, Diabetes Self-management Education (DSME) Program participation remained considerably low. Little is known about disparities of DSME participation, diabetes complications, and ED use by diabetes patients in Florida and yet this information is important for guiding health programs aimed at reducing diabetes burden. Therefore, the objectives of this study were to investigate: (a) disparities of diabetes prevalence and DSME participation; (b) disparities of diabetes-related ED visit risks; and (c) prevalence and predictors of stroke among persons with prediabetes and diabetes.

Behavioral Risk Factor Surveillance System and …

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 …

Effectiveness Of An Evidenced-Based Cognitive Behavioral Therapy Intervention For Adolescents In A School Setting, Sarah Ellen Gray, Kimberly Michaela Carter, Amanda Harper

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

Abstract

The adolescent years are a formative time when rapid hormonal and physical changes stimulate the developing mind. Exposure to poverty, abuse, violence, and lack of peer and social support causes an increase in vulnerability to the development of mental health problems. The COVID-19 pandemic has also exacerbated symptoms of depression and anxiety. Regardless of the risk factors, anxiety and depression continue to be significant health problems, affecting thousands of adolescents yearly in the United States. The first-line treatment recommendation for managing anxiety and depression symptoms is cognitive behavioral therapy (CBT). However, access to a provider for CBT treatment is …

Quality Improvement Project To Improve Patients' Satisfaction Of Care With Implementation Of A Standardized Telephone Communications Pathway, Brandie Haga, Nicole Dunford, Karen Lasater

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

With more and more cancer care being delivered to patients in an outpatient setting, it is becoming essential for clinics to have a standardized telephone communication pathway system. A telephone communication pathway can positively impact patients' quality of life since we know that delaying medical care can negatively impact health, creating otherwise avoidable complications and stress and diminishing patients' confidence in their care. Without a well-developed telephone communication pathway system, symptom management and experience suffer, and the quality of patient care decreases. A strategy was formulated to assess patient satisfaction with a newly implemented standardized telephone communication pathway form using …

Delayed Urethral Obstruction After Migration Of A Ballistic Pellet In An Alpine Wether, Joseph Smith

Faculty Publications and Other Works -- Large Animal Clinical Sciences

A one-year-old alpine wether was presented for emergency evaluation of stranguria. Diagnostics identified a moderately distended bladder and mild dehydration. Preliminary lateral radiographs identified two metallic structures consistent with projectile pellets in the pelvic and perineal regions and no evidence of radiopaque uroliths. A tube cystostomy was performed, and a contrast urethrogram revealed one of the pellets in the perineal region was in proximity to the urethral obstruction. Subsequent radiography and ultrasound identified the pellet as being within the lumen of the urethra. Examination of the trichotomized skin revealed two scars, including a scar over the paralumbar fossa in the …

Implementation Of A Home-Based Walking Program To Address Cancer-Related Fatigue, Mary Catherine Hyatt, Karen Lasater, Michelle Payne

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

Abstract

Background: The non-treatment of cancer-related fatigue (CRF) in adult oncology patients on treatment is a clinical practice issue identified globally and at the local Hematology and Oncology Clinic. Despite the growing evidence supporting physical activity to address CRF, this problem remains prominent. Objective: An 8-week home-based walking program was implemented at the local clinic to address this problem. This project aimed to increase the prevalence of managing CRF and reduce the severity of CRF. Methods: With the provider's recommendation, adult oncology patients on active treatment at the Hematology and Oncology Clinic registered for the program in …

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. …

Non-Opioid Pain Relief: Use Of Vitamin D In Central Appalachia, Christina Brown, Karen Lasater, Teresa Tyson

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

Background: Overdose deaths have exceeded US war fatalities since WWII. Central Appalachia faces high substance use rates and poor health determinants. The opioid epidemic costs $740 billion annually. Providing 100 million chronic pain sufferers alternative pain control is efficacious, equitable, and reduces opioids. The author collaborated with a nurse-led mobile clinic in Central Appalachia to identify evidence-based non-opioid pain relief options for practice translation. In patients with hypovitaminosis D, the body will increase parathyroid hormone production to absorb calcium resulting in skeletal or muscular pain. Vitamin D’s steroid properties reduce inflammation by dampening proinflammatory cytokines. Framework: The Johns Hopkins Nursing …

The Pharmacokinetics And Pharmacodynamics Of Esomeprazole In Sheep After Intravenous Dosing, Joseph Smith, Jessica Gebert, Kailee Bennett, Lisa Sams Ebner, Ryan Flynn, Pierre-Yves Mulon, Lainey Harvill, Olivia Escher, Amanda Jo Kreuder, Joan Bergman, Sherry Cox

Faculty Publications and Other Works -- Large Animal Clinical Sciences

Abomasal (gastric) ulceration is a morbidity in sheep, and currently, there is a paucity of pharmacokinetic and pharmacodynamic data for gastroprotectant drugs reported for this species. The proton pump inhibitor esomeprazole has been used in small animal and human patients for gastroprotection via increasing the gastric pH. The objective of this study was to report the pharmacokinetic parameters and pharmacodynamic effect of esomeprazole in sheep after single intravenous dosing. Four healthy adult Southdown cross ewes had blood collected over a 24  h time period after single intravenous dosing of esomeprazole at 1.0  mg/kg. Abomasal fluid was sampled over 24  h …

Advanced Air Quality Management With Machine Learning, Cheng-Pin Kuo

Doctoral Dissertations

Air pollution has been a significant health risk factor at a regional and global scale. Although the present method can provide assessment indices like exposure risks or air pollutant concentrations for air quality management, the modeling estimations still remain non-negligible bias which could deviate from reality and limit the effectiveness of emission control strategies to reduce air pollution and derive health benefits. The current development in air quality management is still impeded by two major obstacles: (1) biased air quality concentrations from air quality models and (2) inaccurate exposure risk estimations

Inspired by more available and overwhelming data, machine learning …

Translational Models For Advancement Of Regenerative Medicine And Tissue Engineering, Kristin Marie Bowers

Doctoral Dissertations

At the root of each regenerative medicine or tissue engineering breakthrough is a simple goal, to improve quality of healing, thus improving a patient’s quality of life. Each tissue presents its own complexities and limitations to healing, whether it is the scarring nature of tendon healing or the mechanical complexity driving bone regeneration. Preclinical, translational models aim to reflect these complexities and limitations, allowing for effective development and refinement of tissue engineered therapeutics for human use. The following body of work explores several of these translational models, both utilizing them for tissue regenerative therapy development and evaluating the benefits and …

Utilizing Ultra-Performance Chromatography High-Resolution Mass Spectrometry To Investigate Fatty Acid Mediated Antibiotic Tolerance, Brittni Woodall

Doctoral Dissertations

The lipid membrane is the first component necessary to sustain life. To maintain homeostasis, segregate cellular machinery, provide protection from the environment, and reproduce, an organism must establish a boundary in which the processes can occur. Throughout the last two decades, research has propelled our knowledge of lipid membranes much beyond original hypotheses. Once thought of to be static and uniform, the understanding of the lipid membrane has evolved to encompass a structure that is responsive, unique, and intricately constructed by the organism itself. By chance or by choice, organisms adapt the lipid membrane according to the environment for which …

Serving American Veterans: A Review And Analysis Of Gaps In Service In The Needs Of Veterans, Mary Elisabeth Germann

Baker Scholar Projects

The United States Department of Veterans Affairs is the agency of the federal government that is responsible for providing benefits, health care, and cemetery services to US military Veterans and their families. About a quarter of the nation’s population, approximately 70 million people, are potentially eligible for VA benefits and services because they are veterans, family members, or survivors of veterans. Due to this expansive demand, the United States has developed the most comprehensive system of Veterans assistance programs in the World. But many argue that the US VA still falls short of expectations and fails to fulfill the needs …

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 …

Faith Influences On Health Of Rural Appalachian Older Adults In East Tennessee: An Ethnonursing Study, Karina Elizabeth Strange

Doctoral Dissertations

As the U.S. older adult population increases and diversifies, healthcare providers need innovative, cost-effective, and culturally congruent approaches to gerontological nursing care. Decades of multidisciplinary evidence demonstrate that spirituality enhances older adult holistic health. However, although research about spirituality and nursing has become more culturally diverse, little is known about spirituality-health linkages of rural Appalachian older adults (RAOAs). This knowledge gap is significant because Appalachia leads the country in mortality related to chronic comorbidities such as heart disease, cancer, and depression. Given age, poverty, limited transportation, and health provider shortage areas, RAOAs experience severe health disparities. Moreover, spirituality is an …

Evaluation Of Treatment Options And Investigation Of Pathogenesis Of Chytridiomycosis In North American Salamanders, Anastasia Elaine Towe

Doctoral Dissertations

Chytridiomycosis, a cutaneous fungal disease caused by two related fungi, Batrachochytrium dendrobatidis (Bd) and Batrachochytrium salamandrivorans (Bsal), is a major cause of amphibian population declines worldwide. Bd has a broad distribution, covering every continent except for Antarctica. Meanwhile, Bsal is currently restricted to Europe and Asia. Treatment options for both Bd and Bsal remain a major area of concern for wild populations. Recently, implants for long-term, parenteral antifungal drug administration have shown some promise in fungal diseases in wildlife. We investigated the safety and efficacy of an intracoelomic implant of the antifungal drug terbinafine in greater …

The Correlation Between Exercise And Burnout In Student Nurses, Drew Janes

Chancellor’s Honors Program Projects

No abstract provided.

Anxiety-Like Behavior In C57bl/6j Mice Is Sexually Dimorphic And Altered By Buprenorphine, Ohm Sharma

Chancellor’s Honors Program Projects

No abstract provided.

Examining Sex Differences In Own And Other-Race Face Processing In Infancy, Hannah E. Greene

Chancellor’s Honors Program Projects

No abstract provided.

Effect Of Skin Microbiota On Acne, Chloe A. Biggs

Chancellor’s Honors Program Projects

No abstract provided.

The Effects Of Clonidine On Neonatal Abstinence Syndrome Patient Outcomes, Claire E. Flatt

Chancellor’s Honors Program Projects

No abstract provided.

Ballad Health: Understanding Appalachia's Regional Healthcare Monopoly, Meredith A. Bailey

Chancellor’s Honors Program Projects

No abstract provided.

Healthcare Disparities And Hispanic Immigrants: A Systematic Review Of The Literature, William C. Greenman Iii

Chancellor’s Honors Program Projects

No abstract provided.

Ballad Health: Understanding Appalachia’S Regional Healthcare Monopoly, Meredith A. Bailey

Baker Scholar Projects

The Ballad Health merger of 2018, which combined the now 21 hospitals in the region under one organization, has impacted the healthcare landscape in Northeast Tennessee and Southwest Virginia. Historically, Appalachia has had to persevere through primary physician shortages, a lack of specialty care, geographic obstacles to accessing healthcare, challenges related to substance abuse, and much more. Since the merger of Mountain States Health Alliance and Wellmont Health System, little research has been done to assess the perceived impact the aggregation of providers has had on the population it serves. This study utilizes an online survey to better understand the …

The Pink Tax: A Comparative Case Study Between Tennessee And Washington State, Megha Chitturi

Baker Scholar Projects

The imposition of an additional luxury tax on menstrual health products, otherwise referred to as the “Pink Tax” or the “Tampon Tax”, is present in some states while absent in others. The decision to repeal such a tax is one that has proven to be critical, as it removes the connotation that such products are of “luxury” and make them more accessible to menstruators throughout the state. As of 2023, twenty-three states have eliminated the tax. The state of Washington falls under that parameter while Tennessee does not. The purpose of this undergraduate honors thesis is to explore the potential …

The Development Of Health System Resiliency: How Kenya's Experience With Malaria Impacted Its Reaction To The Covid-19 Pandemic, Zoe A. Ward

Baker Scholar Projects

Public health scholars have recently focused on health system resiliency to explain how previous experiences dealing with public health crises impact the healthcare sector, public behavior, and policy response to novel crises. However, it is unclear how resiliency develops. This study contributes by testing whether a health system’s experience with a health emergency and significant interventions impacts the response to a novel crisis. This research asks, “How has Kenya’s experience with malaria impacted its response to COVID-19?” Using the United States Agency for International Development (USAID) Malaria Indicator Survey (MIS), I develop a malaria adherence score to measure county-level compliance …

When The Rural Hospital Closes: An Analysis Of Acute Health Impacts Following Closure Of Rural Hospitals In Appalachia, Bret M. Berry

Chancellor’s Honors Program Projects

No abstract provided.

Development Of Surface-Modified Liposomes For Drug Delivery Applications, Megan Louise Qualls

Doctoral Dissertations

Liposomes are spherical vesicles composed of a lipid bilayer membrane that assembles around an internal aqueous core. This duality gives liposomes the ability to encapsulate both hydrophobic cargo within the lipid bilayer and hydrophilic cargo in the aqueous core, making them versatile molecular carriers for drug delivery. Liposome platforms have many advantages and are promising drug delivery carriers, and research is ongoing to improve their designs for continued clinical applications. Many liposome types have been developed, but further work is needed to improve surface modification, site-specific targeting, and triggered cargo release in order to further the therapeutic applications of these …

A Machine Learning Approach For Predicting Clinical Trial Patient Enrollment In Drug Development Portfolio Demand Planning, Ahmed Shoieb

Masters Theses

One of the biggest challenges the clinical research industry currently faces is the accurate forecasting of patient enrollment (namely if and when a clinical trial will achieve full enrollment), as the stochastic behavior of enrollment can significantly contribute to delays in the development of new drugs, increases in duration and costs of clinical trials, and the over- or under- estimation of clinical supply. This study proposes a Machine Learning model using a Fully Convolutional Network (FCN) that is trained on a dataset of 100,000 patient enrollment data points including patient age, patient gender, patient disease, investigational product, study phase, blinded …