Medicine and Health Sciences Commons^™

Investigating The Pi3k/Akt/Atm Pathway, Telomeric Dna Damage, T Cell Death, And Crispr/Cas9-Mediated Gene Editing During Acute And Chronic Hiv Infection, Sushant Khanal

Electronic Theses and Dissertations

Human Immunodeficiency Virus (HIV) infection initiates major metabolic and cell- survival complications. Anti-retroviral therapy (ART) is the current approach to suppress active HIV replication to a level of undetected viral load, but it is not a curative approach. Newer and sophisticated gene editing technologies could indeed be a potent antiviral therapy to achieve a clinical sterilization/cure of HIV infection. Chronic HIV patients, even under a successful ART regimen, exhibit a low-grade inflammation, immune senescence, premature aging, telomeric DNA attrition, T cell apoptosis, and cellular homeostasis. In this dissertation, we investigated CD4 T cell homeostasis, degree of T cell apoptosis, an …

Correctional Career Pathways: A Reentry Program For Incarceration, Taylor M. Dula

Electronic Theses and Dissertations

For the past several decades, the United States led the world in incarceration rates. With nearly 2.3 million people being held in state or federal prisons or local jails in 2019, incarceration rates in the United States are over four times higher than in other developed countries. Disparities exist by gender, race, ethnicity, and other special populations. Males are 13 times more likely to be incarcerated than females. Additionally, black males are 5.7 times and Hispanic males are 2.8 times more likely to be incarcerated than white males. Individuals who experience incarceration have poorer mental and physical health outcomes. People …

Species Data And Vector Modeling: Evaluating Datasets For Improved Models Of Ixodes Ricinus Tick Distribution In Europe Under A Changing Climate, Steven Jones

Electronic Theses and Dissertations

To increase capacity for monitoring and surveillance of tick-borne diseases, publicly available tick distribution and climate change datasets are required to create accurate predictive distribution models. It is difficult, however, to assess model accuracy and utility when using incomplete datasets.  The more recent development of comprehensive tick databases for Europe and availability of climate change scenarios from multiple IPCC Assessment Reports allows for improved modeling efforts. Multiple tick datasets were combined and three climate change projections were compared by predicting current and future distributions of Ixodes ricinus ticks in Europe using the MaxEnt species distribution model. Overall, much of Europe …

Prevalence And Predictors Of Polypharmacy In Adolescents Who Have Engaged In Sexually Abusive Behaviors, Rebecca Gilley

Electronic Theses and Dissertations

Polypharmacy, or the concurrent use of multiple medications, is associated with detrimental outcomes for patients and has gathered increasing attention within the scientific clinical literature. Pediatric populations warrant special consideration for the practice of polypharmacy, as medication effects are more pronounced in youth and adverse effects may have a lasting impact on development. This dissertation study examined psychotropic prescribing practices in a sample of adolescents who have engaged in sexually abusive behaviors, a subset of justice-involved youth who are at risk for polypharmacy. General prescribing trends were examined, and a principle components analysis involving variables associated with risk of polypharmacy …

When The Costs Outweigh The Benefits: Examining Variations In Nulliparous, Term, Singleton, Vertex And Elective Cesarean Delivery Rates Across The United States, 2016-2020, Kathleen Tatro

Electronic Theses and Dissertations

The overutilization of cesarean deliveries is a major public health issue in the United States (U.S.). The rates of cesarean deliveries have increased substantially from the mid 1990s. Low-risk, defined as nulliparous, term, singleton, vertex (NTSV) pregnancies with no medical indication of need, and elective cesarean deliveries have been implicated as drivers of these increases. Elective cesarean deliveries are NTSV cesarean deliveries in which no trial of labor was attempted. There is a lack of clear rationale as to the noted increases in cesarean delivery rates as the evidence shows that these procedures provide no additional health benefits to mothers …

Acute Effects Of Match Play Induced Fatigue On Jump Performance In Collegiate Women's Volleyball, Grayson Flora

Electronic Theses and Dissertations

This study investigated changes in maximal jump performance in response to match play induced fatigue. During six sets of tournament match play, seven National Association of Intercollegiate Athletics women’s volleyball athletes accumulated a mean Player Load of 758.6±216.89 au (measured via microsensor accelerometry), and mean session rate of perceived exertion of 1184.1±363.2. Repeated measures ANOVAs were used to identify change with Hedge’s g effect sizes used to assess magnitude of change. Short recovery stress scale results indicated elevated stress (ES=1.401 to 1.588) and decreased recovery (ES = -1.358 to -1.848) 24 hours post-match, trending towards baseline 48 hours post-match. Countermovement …

Cyclic Di-Gmp Regulates Motility, Biofilm Formation, And Desiccation Tolerance In Acinetobacter Baumannii, Garrett Reynolds

Electronic Theses and Dissertations

Acinetobacter baumannii is an increasingly multidrug-resistant pathogen contributing to hospital-acquired infections necessitating the discovery of novel treatments. A bacterial second messenger, cyclic diguanosine monophosphate (cyclic di-GMP), can regulate various persistence factors that are potentially advantageous for survival in hospital environments. Cyclic di-GMP–modulating enzymes and cyclic di-GMP–binding effectors predictively are encoded in the Acinetobacter baumannii genome. I hypothesized that cyclic di-GMP controls motility, biofilm formation, and desiccation tolerance in Acinetobacter baumannii. Disrupting cyclic di-GMP–modulating enzymes or cyclic di-GMP–binding effectors should alter the regulatory effectiveness of these phenotypes. I tested the multidrug-resistant isolate Acinetobacter baumannii strain AB5075 and identified several transposon …

Cognitive Preference And Skill Acquisition: The Relationship Between Student Nurse Anesthetists And Certified Registered Nurse Anesthetists Thinking Styles, Thomas Diller

Electronic Theses and Dissertations

Decision-making in healthcare is a complex and, at times, uncertain process. In the United States Certified Registered Nurse Anesthetists (CRNA) administer the majority of anesthesia. Nurse Anesthetists must draw on their educational background, clinical experience, and cognitive processes to make sound clinical judgments. To avoid errors understanding the relationship between cognitive preference and skill acquisition is critical. This study was designed to describe the cognitive preferences of Student Nurse Anesthetists (SRNAs) and CRNAs in the United States. The 2 cognitive preferences explored are rational (analytical) and experiential (intuitive) decision-making.

The researcher used a quantitative, cross-sectional, descriptive correlational design. The researcher …

An Investigation Into The Use Of Biomechanical And Performance Data From Vertical Jump Testing To Monitor Competitive Weightlifters, Dylan Suarez

Electronic Theses and Dissertations

This investigation aimed to employ novel analyses to longitudinal jump testing data gathered from competitive weightlifters to identify how certain biomechanical and performance characteristics obtained from the countermovement jump (CMJ) relate to changes in weightlifting performance over time and if they can differentiate higher and lower performers. A linear mixed-effect model was used to assess and compare the ability of countermovement jump height and net-impulse to predict Sinclair weightlifting total. CMJ force-time waveforms were compared in cross-sectional and repeated measures analyses to distinguish the force application patterns of higher-performing weightlifters and if they change over extended periods of training. It …

Overview Of Transition Care Clinics And Patient No-Shows, Manul Awasthi

Electronic Theses and Dissertations

Introduction

Transition care clinics (TCCs) have proven to be effective in meeting the time-sensitive needs of patients in the post-discharge period and ensuring smooth transitions of patients from hospital to home. These clinics have led to lower readmissions, lower emergency department visits, cost savings, and lower rates of other adverse events following discharge. However, TCCs, including the East Tennessee State University Family Medicine (ETSU-FM) TCC have been facing high rates of patient no-shows.

Aim

The aim of this dissertation is to identify the different components and outcomes of TCC based on the literature. We further aim to analyze the TCC …

Investigating Force-Velocity Profile Alterations And Methodology After Traditional Resistance Training, Joseph D'Amato

Electronic Theses and Dissertations

The purposes of this dissertation were to examine the agreement the agreement between double integration using the trapezoidal method and measurements for push-off distance to create force-velocity profiles, examine the change in push-off distance between loading conditions when force-velocity profiling, and to observe the alterations in mechanical outputs of force-velocity profiles after 15-weeks of off-season training. The major findings are as followed. Using double integration with the trapezoidal method may be a reliable way to estimate push-off distance, despite a small systematic bias. This bias should have negligible effects on push-off distance and therefore not alter or effect calculations in …

Positive And Negative Deviant Counties: Identification Of Factors Associated With Health Outcomes, Olivia Egen

Electronic Theses and Dissertations

Rural counties in the United States vary drastically on metrics related to socioeconomic status and dominant economic industry as well as health behaviors and outcomes. This study sought to understand the underlying structural reasons why some rural counties have better or worse than expected health outcomes using a positive deviance (PD) approach. The study aimed to: 1) create an area deprivation index and divide counties into quartiles using the index; 2) identify positive, negative, and non-deviant counties using health outcome metrics; 3) analyze differences between deviance on a variety of local public health system metrics; and 4) analyze differences between …

Assessing Best Practices, Perceptions, And Barriers To Breastfeeding In The Appalachian Region, Melissa White

Electronic Theses and Dissertations

Background: Breastfeeding protects against a variety of adverse health outcomes for mothers and babies. Global best practices, known as the Baby-Friendly Hospital Initiative (BFHI), have been developed to support the initiation and exclusivity of breastfeeding during the post-delivery hospital stay. The aims of this study were to explore the literature related to the impact of the BFHI on breastfeeding disparities in the U.S.; compare the impact of exposure to these best practices on exclusive breastfeeding rates in Appalachian and non-Appalachian hospitals; and to understand knowledge, perceptions, and barriers to breastfeeding of postpartum mothers receiving care in a Northeast Tennessee OB/GYN …

Early Detection Of Atypical Motor And Neurobehavior Of Infants At Risk Secondary To Opioid Exposure: A Prospective Study, Kara Boynewicz

Electronic Theses and Dissertations

Prenatal opioid exposure has been studied in relation to infants' medical outcomes. However, large gaps exist in the literature supporting early identification of atypical neurobehavior and motor development of infants with prenatal opioid exposure. The purpose of the study was to investigate whether prenatal opioid exposure has a negative influence on a newborn infant’s neurobehavior and motor development to aid in the early identification of potential delays. Using a prospective quasi experimental design, infants motor development using the Test of Infant Motor Performance (TIMP) and neurobehavior using the NICU Neonatal Network Scale (NNNS) was assessed on 58 infants in a …

Knockdown Of C. Elegans Nad Kinases Nadk-1 Or Nadk-2 Induces An Antioxidant Response Without Affecting Lifespan, Henry Gong

Electronic Theses and Dissertations

Nearly all multicellular organisms show changes in redox balance with aging leading to oxidative damage of macromolecules. This study investigated the role of the [NADP⁺]/[NADPH] redox couple in aging. This redox couple plays an important role in maintaining tissue redox balance and becomes slightly more oxidized in aged tissues. NADPH is a major source of reducing equivalents for enzymes that detoxify hydrogen peroxide. However, catalase detoxifies hydrogen peroxide independently of NADPH. But catalase is absent from mitochondria, a major source of hydrogen peroxide, where instead glutathione plays the major role in hydrogen peroxide detoxification in an NADPH-dependent manner. …

Self-Measured Blood Pressure Monitoring In Hypertension Control: The Role Of Social Determinants Of Health, Current State In The United States, And Future Directions, Adekunle Oke

Electronic Theses and Dissertations

Hypertension, a medical condition, predisposes to other cardiovascular diseases, and can be impacted by the social determinants of health (SDOH). Self-measured blood pressure monitoring (SMBP) is an evidence-based approach to hypertension control, but not much is known about the influence of SDOH on SMBP. This dissertation aims to: 1) highlight the SDOH factors whose relationship with SMBP have been explored in research studies; 2) examine the relationship between SDOH and SMBP among United States (U.S.) adults with high blood pressure; and 3) examine the current state of SMBP in the U.S., highlight policy implications from the empirical study and provide …

Effect Of Chemical And Physical Enhancers On The Skin Permeation Of Cromolyn Sodium, Miranda Holman

Electronic Theses and Dissertations

Cromolyn sodium (CS) has clinically shown to be an effective topical remedy for atopic dermatitis, however its physiochemical properties prevent efficient passive drug delivery beyond the outermost skin layer. This project aimed to optimize CS gel formulations and applications to improve drug delivery to the dermis of skin by examining various topical enhancement strategies. Oleic acid, salcaprozate sodium, and microneedles were investigated as enhancers for their effect on skin permeation of CS. In vitro permeation studies across dermatomed porcine ear skin tested CS gels to determine 24-hour drug permeation profiles and skin layer distribution of drug. Further, extraction method efficiency, …

Dental Students' Perceptions Of Dental Hygienists' Education And Scope Of Practice, Cynthia Metzger

Electronic Theses and Dissertations

Oral health is strongly correlated to systemic health in the United States. Dental professionals play a significant role in addressing the oral health and prevention of disease for populations in the United States. Because many areas in the United States lack access to dental care, the federal government considers dental hygienists part of the solution. It is now paying attention to restrictive dental hygiene scope of practice rules in each state. State dental boards, comprised mainly of dentists, make these rules based on their perception of dental hygienists' lack of education. This study explored fourth-year dental students' perceptions of the …

2-Day Vs. 4-Day Training Cessation Following A Step Taper In Competitive And Recreational Powerlifters, Benjamin Burke

Electronic Theses and Dissertations

The purpose of this study was to compare differences in maximal strength, perceived recovery and stress state, and body composition alterations in powerlifters undergoing a 2-day or 4-day period of training cessation following a step taper. Ten participants completed a 6-week powerlifting specific training protocol. Body composition, perceived recovery and stress state, and maximal strength in the back squat (BS), bench press (BP), and deadlift (DL) were assessed prior to the overreach week (week 5) and either 2-days or 4-days after the taper. Alpha criterion was set at p≤0.05. There were statistically significant increases in BP (pp=0.03) …