Medicine and Health Sciences Commons^™

A Descriptive Study Of The Organizational Attributes Of Exemplar Tennessee Hospitals., Sharron Rutledge Grindstaff

Electronic Theses and Dissertations

Tennessee's registered nurse vacancy rate is the highest in five years and the nursing shortage has dramatically impacted all portions of the state. The purpose of this study was to describe organizational attributes of exemplar Tennessee hospitals, as perceived by Chief Nurse Executives, which may influence the recruitment and retention of registered nurses.

In this study, 52 Tennessee hospitals were identified as exemplars of quality patient care, organizational policy, and administration. Their Chief Nurse Executive's were surveyed utilizing a Hospital Characteristics Questionnaire and the Organizational Support Subscale from the Nursing Workforce Index Revised (NWI-R). The hospital characteristics and organizational attributes …

Characterization Of Seca-Sod Operon In Borrellia Burgdorferi., Tonya Lynn Nichols

Electronic Theses and Dissertations

Borrelia burgdorferi, the causative agent of Lyme disease, has been characterized as a microaerophilic spirochete. O2 consumption and utilization potentially yield reactive oxygen intermediates, such as superoxide, hydroxyl radicals, and hydrogen peroxide. This study investigated the expression of the sod gene, which encodes the only, identified oxidative defense mechanism in B. burgdorferi. Using primer extension analysis and RT-PCR, it was found that sod and secA are organized as a single transcriptional unit under the control of σ70-like promoter upstream of the secA open reading frame. Generally, gene expression decreases with increased distance from the promoter; however, secA expression was observed …

Behavioral Changes In Adult C57bl/6j Mice Following Prenatal Exposure To Ethanol., Kevin Wade Nunley

Electronic Theses and Dissertations

Fetal Alcohol Syndrome (FAS) labels children with physical, mental and behavioral deficits exposed to alcohol in utero. Current research indicates that timing of alcohol exposure of the embryo/fetus is a critical determinant of the behavioral deficits associated with FAS. This study represents a model for binge drinking, in which C57BL mouse embryos were exposed to alcohol during 2 separate critical periods of brain development, gestational day (GD) 7 or 8. As adults, the offspring were tested to determine if loco-motor activity and emotional reaction to a novel environment had been affected. Significant differences due to treatment and sex were …

Using An Importance-Performance Analysis Of Summer Students In The Evaluation Of Student Health Services., Candice Cline Duvernois

Electronic Theses and Dissertations

Hitherto, students have not evaluated the importance and performance of services provided by the student health service (SHS) at East Tennessee State University. An evaluation could provide valuable feedback to providers and administration.

In 2001, there were 944 student visits in the summer sessions. Approximately 256 students were offered a survey containing an Importance-Performance scale of which 151 (59.0%) responded. The I-P scale rates the importance students place on healthcare services and the performance of the SHS in delivering services (i.e., patient satisfaction).

Based on mean scores, students reported high importance, high performance on urgent care, pharmacy and patient education. …

Molecular Studies Involving The Rev Protein Of Caprine Arthritis Encephalitis Virus And Visna Virus., Bridget Michele Graves

Electronic Theses and Dissertations

Caprine Arthirtis Encephalitis Virus (CAEV) and Visna Virus are two viruses of the lentivirus family. They encode three structural genes (gag, pol, and env) and two regulatory genes (rev and tat). The Rev protein regulates Gag, Pol and Env expression by transporting their mRNAs to the cytoplasm by binding to the RRE (Rev Response Element) found on their mRNAs. Previous studies have indicated that Rev may be toxic to transfected cells, overexpression of exogenous RREs or a better binding RRE can inhibit Rev activity and Rev-C (CAEV Rev) can trans-activate RRE-V (Visna Virus …

The Description And Comparison Of Feature Retention Patterns For Children With Phonological Impairment Developmental Apraxia Of Speech And Typically Developing Children., Amanda N. Lambert

Electronic Theses and Dissertations

The purpose of the present study was to compare feature retention patterns between children developing speech typically (TD) and children with phonological impairment (PI) and to discuss these findings in terms of characteristics, severity, and implication for the identification of developmental apraxia of speech (DAS). A second purpose was to determine if a relationship exists between phonological knowledge and feature retention.

This study consisted of a PI group and a TD group of children, ages four to six. A 245-item speech sample was collected from each subject. Feature retention percentages as well as percent correct underlying representation (PCUR) were calculated …

An Analysis Of Risk Factors Associated With High Rates Of Cesarean Births In Three Selected Northeast Tennessee Hospitals., Karen Stewart-Hall

Electronic Theses and Dissertations

This study consists of an analysis of hospital discharge data from three Northeast Tennessee hospitals to identify maternal demographic factors that may be linked to higher rates of cesarean sections in this region of Appalachia. Maternal age, race, insurance status, length of stay, and birth weight were evaluated to identify regional trends in the prevalence of these factors over a two-year period.

There were 1,678 (23.3%) singleton live births by cesarean section of which 7.6% were repeat cesarean section deliveries. Less than one percent of the 7,181 births were vaginal births after cesarean (VBAC) delivery. Overall, insurance and maternal age …

Characterization Of 50s Ribosomal Subunit Assembly Inhibition In Erythromycin Treated Escherichia Coli Cells., Jerry Edward Usary

Electronic Theses and Dissertations

Erythromycin has long been recognized for its ability to inhibit protein synthesis by interfering with mRNA translation on the bacterial ribosome. We have recently shown that erythromycin also inhibits the assembly of the 50S ribosomal subunit in growing bacterial cells. The nature of this assembly inhibition has been investigated using ³H-uridine pulse-chase labeling of control and erythromycin treated E. coli cells.

Subunit assembly was examined by sucrose gradient centrifugation of labeled cell lysates. Normal assembly kinetics of subunit assembly were observed in control cells at 37°C. Formation of the 30S subunit was completed by 7.5 minutes and assembly of …

Supervisory Feedback In Speech-Language Pathology: Preferences And Practices., Janet Michelle Gurley

Electronic Theses and Dissertations

Research in the area of clinical supervision has historically been limited, especially in the field of speech-language pathology. Furthermore, those few studies that do exist were primarily published during the decade of the 1980's. Clinical supervision, and specifically its critical component of supervisory feedback, is crucial to all clinical training programs. However, supervision research only mentions the topic of supervisory feedback and neglects the relationship between supervisory feedback preferences and actual supervisory practices. This study was designed to identify and compare supervisor and supervisee preferences and perceptions regarding supervisory feedback, to relate these preferences to a continuum-based model of clinical …

Perceived Barriers To The Teaching Of Critical Thinking Skills By Nursing Faculty In Generic Bsn Programs In Tennessee, Renee C. Shell

Electronic Theses and Dissertations

Teaching critical thinking is a national education goal. The ability to think critically is considered an essential skill of nursing graduates and is a necessary component of competent nursing practice. Therefore, nursing programs must address critical thinking for accreditation. The literature reports that teachers in all areas of education are having difficulties infusing critical thinking teaching strategies into their current teaching practices and critical thinking is lacking in new nursing graduates. This research study sought to identify barriers to the implementation of critical thinking teaching strategies as perceived by nursing faculty in generic, BSN programs in Tennessee. Data were collected …

Signaling Mechanisms For Muscarinic Receptor-Mediated Coronary Vasoconstriction In Isolated Rat Hearts, Yi Zhang

Electronic Theses and Dissertations

The signaling mechanisms for muscarinic receptor-mediated vasoconstriction in coronary resistance arteries were studied in KCl-arrested isolated rat hearts perfused at a constant flow rate. The cholinergic agonists acetylcholine and bethanechol were given by bolus injection or constant infusion. The coronary vascular resistance was monitored by measuring the changes in perfusion pressure. The selective muscarinic agonist bethanechol caused a similar vasoconstrictor response as ACh, but with less potency and efficacy. Bolus injection of bethanechol evoked a phasic vasoconstriction in a dose-dependent manner, while infusion of bethanechol evoked a tonic vasoconstriction without producing tachyphylaxis. Coronary vascular responses to bethanechol were further examined …

Identifying The Behavior, Attitudes, And Knowledge Of Tobacco Use Among Students Enrolled In Orientation Courses In Six Community Colleges In The Tennessee Board Of Regents System, G. E. Boone

Electronic Theses and Dissertations

The purpose of this study was to examine the behavior, attitudes, and knowledge regarding tobacco use of students enrolled in orientation courses in Tennessee community colleges. The six community colleges selected for the study were members of the Tennessee Board of Regents system that offered mandatory orientation courses. Data were collected by use of the College Tobacco Behavior, Attitude, and Knowledge Survey . A response rate of (72.5%) from 700 students was analyzed. Three research questions guided the study and 17 null hypotheses were formulated and tested at the.05 alpha level of significance. Data were analyzed by using t -tests, …

Entry-Level Competencies Needed By Bsns In Acute Healthcare Agencies In Tennessee In The Next Ten Years, Marjorie S. King

Electronic Theses and Dissertations

The research focused on the identification of entry-level competencies needed by Bachelor of Science in Nursing (BSN) graduates who will begin employment in acute healthcare agencies in the next 10 years in Tennessee. The purpose of the study was to gain increased awareness of the competencies needed by graduates of BSN programs in Tennessee in order to meet the demands of the acute healthcare agencies, in light of present and anticipated changes in the healthcare delivery system. The opinions of nurse educators, nurse administrators, recently graduated BSNs, and experienced BSN graduates were solicited to assess congruency of perceptions. In addition, …

The Nature, Scope, And Consequences Of Drug And Alcohol Use Of Students Enrolled At Three Southern Appalachian Community Colleges, Jewel D. Morgan

Electronic Theses and Dissertations

The primary purpose of this study was to determine the nature, scope, and consequences of drug and alcohol use by students enrolled at three southern Appalachian community colleges: Mountain Empire Community College (MECC) in Virginia, Northeast State Technical Community College (NSTCC) in Tennessee, and Southwestern Community College (SCC) in North Carolina. An additional purpose was to use this information to formulate recommendations for new and improved preventive substance-abuse programs. The design for this study was descriptive research. The Core Alcohol and Drug Survey (CORE) was selected as the appropriate instrument for use in this study. The 23-item questionnaire was designed …

In Vitro Assessment Of The Toxicity Of Cocaine And Its Metabolites In The Human Umbilical Artery, Tessa L. Long

Electronic Theses and Dissertations

An in vitro model was used to assess the effect of cocaine and its metabolites on the umbilical artery. Objectives were to pharmacologically confirm the presence of adrenergic innervation using tyramine, evaluate the ability of cocaine, benzoylecgonine, norcocaine and cocaethylene to potentiate vasoconstriction by serotonin and norepinephrine, examine the ability of ketanserin to block the enhanced vasoconstriction produced by cocaine, and determine displacement of 3 H-ketanserin by serotonin, norepinephrine, tyramine and mianserin. The vasoconstrictive effect of tyramine (100 μM) was enhanced in the presence of cocaine by 257%. Vasoconstrictive effects of serotonin and norepinephrine were significantly enhanced by cocaine by …

Quantal Mechanisms Underlying Stimulation-Induced Augmentation And Potentiation, Hong Cheng

Electronic Theses and Dissertations

Repetitive stimulation of motor nerves causes an increase in the number of packets of transmitter ("quanta") that can be released in the ensuing period. This represents a type of conditioning, in which synaptic transmission may be enhanced by prior activity. Despite many studies of this phenomenon, there have been no investigations of the quantal mechanisms underlying these events, due to the rapid changes in transmitter output and the short time periods involved. To examine this problem, a method was developed in which estimates of the quantal release parameters could be obtained over very brief periods (3 s). Conventional microelectrode techniques …

The Relationship Between Rural Low-Income Women's Knowledge And Short-Term Duration Of Breastfeeding, Jefferey J.A. Enstad

Electronic Theses and Dissertations

Although patterns of breastfeeding initiation and duration among American women have made dramatic changes over the past 100 years, these patterns have not been studied in rural, low-income women. Furthermore, even less is known about the characteristics of rural low-income women who practice short-term breastfeeding. Therefore, the problem under investigation was to explore the relationship between rural low-income women's knowledge and short-term duration of breastfeeding. The objectives of the study were to: 1) describe what are the characteristics of rural low-income women who breastfeed for four or more weeks postpartum, 2) describe what sources did they receive breastfeeding instruction and …

Differences In Body Image And Depression Scores In Postmenopausal Women Who Do And Do Not Take Hormone Replacement Therapy, Doreen M. Boomsma

Electronic Theses and Dissertations

The purpose of this descriptive study was to examine differences in depressive symptomology and perceived body image in postmenopausal women who currently used HRT with women who never used HRT and women who had previously used HRT but were currently not. Few medical treatments presently available for postmenopausal and menopausal women have such substantial benefits, and risks, as hormone replacement therapy (HRT). The study is based on findings that document the use of HRT in preventing chronic illnesses that afflict elderly women. Chronic illness and disability has been shown to increase the incidence of depression in the general population. Chronic …

Collegiate Activities That Influence Adult Physical Fitness Habits, Linda L. King

Electronic Theses and Dissertations

This descriptive/correlational study analyzed the perception of recent graduates regarding the effectiveness of the college environment at Milligan College in influencing adult fitness habits. Graduates were divided into five activity level groups through a self-report of physical activity. The purposes of the research were to determine if significant differences existed between the dependent variable, activity level, and the independent variables such as: (a) participation in specific college activities, (b) preferences for types of exercise, (c) social influence, (d) influence of a required freshman fitness course, and (e) environmental barriers. A profile of the student most likely to exercise after graduation …

Comparison Of Beta-Adrenoceptor Coupled Camp Production In Cultured Human Mononuclear Leukocytes And Myometrial Cells, Yu-Li Liu

Electronic Theses and Dissertations

$\beta\sb2$-Adrenoceptor ($\beta\sb2$-AR) agonists, such as terbutaline, are used as tocolytic agents in the treatment of preterm labor. $\beta$-Adrenoceptor stimulation relaxes myometrium through specific receptors coupled through Gs to adenylyl cyclase (AC) that catalyzes the conversion of ATP to cAMP. The purpose of this study was to compare $\beta$-adrenoceptors and cAMP production in cultured human leukocytes and myometrial cells, and to determine the importance of $\beta$-adrenoceptors and cAMP production in isoproterenol-induced myometrial relaxation. $\sp{125}$I-iodopindolol was used to assess $\beta$-adrenoceptor affinity and number cAMP levels were analyzed before and after stimulation by isoproterenol, AlF$\sb4\sp-$, forskolin, and PGE$\sb1$. Isometric recording was used to …

Characterization Of Angiotensin Ii Receptor Subtypes In The Brain, David L. Saylor

Electronic Theses and Dissertations

The present studies explore binding, distribution, and function of angiotensin II (AII) receptors (AT$\sb1$ and AT$\sb2)$ in the brain. The discovery that sulfhydryl reducing agents masked some but not all AII receptors in the brain prompts an evaluation of commonly used binding assay buffer constituents. EDTA enhances binding (40%) at both AT$\sb1$ and AT$\sb2$ nuclei, while bacitracin did not alter binding at either receptor subtype. Phenanthroline and BSA differentially altered binding at AT1 (220% of control) and AT$\sb2$ (118% of control) receptors. The results indicate that phenanthroline and BSA would be poor buffer constituents for studies comparing binding at AT$\sb1$ …

Gross And Histological Features Of A Myofascial Trigger Point In The Upper Trapezius, Kathryn E. Levee

Electronic Theses and Dissertations

The purpose of this study was to precisely locate, in living humans, a myofascial trigger point associated with the upper portion of the trapezius muscle (TrP1) that refers pain to the head and neck and to determine if this point is associated with anatomical structures. This study is descriptive and utilizes data from measurements of the location of TrP1 in relation to anatomical landmarks, of pressure sensitivity overlying the trigger point and electromyography recordings in localizing the trigger point. Information obtained from living humans was used to determine anatomical correlation to structures in cadavers. Results indicated there is little variability …

Southern Appalachian Settlement Schools As Early Initiators Of Integrated Services, Eloise H. Jurgens

Electronic Theses and Dissertations

This historical-descriptive study examined Southern Appalachian settlement schools as early initiators of integrated health and social services with education from the 1900s through the 1970s. Three schools were studied: Hindman Settlement School (KY), Pine Mountain Settlement School (KY) and Crossnore School, Inc. (NC). The purpose of the study was to determine the type and extent of services provided, the relationship of the settlement schools with their respective county public school system, and the transfer, if any, of integrated services from the settlement schools to public schools as the public schools took over educational responsibilities once offered by the settlement schools. …

A Case Study Of An Elementary School-Based Health Clinic, Sheila K. Jones

Electronic Theses and Dissertations

The purpose of this study was to perform a qualitative analysis of an elementary school-based health clinic (SBHC). This situational analysis was performed to further understand the impact of accessible primary health care on an elementary school population. Data were collected through 30 participant interviews of parents, educators and medical personnel. Additional data were collected through the clinic files, and a t-test was used to compare the attendance and achievement data of clinic consumers for the clinic year against records from the previous year. The researcher presented information on the steps of SBHC development to include community campaign procedures. The …

Pain Management: South Dakota Advanced Prepared Nurses' And Physicians' Knowledge, Attitudes, And Perceived Barriers, Rebecca B. Reed

Electronic Theses and Dissertations

The most common reason patients seek health care is for the relief of pain. One of the most important roles health care providers serve is to assist patients in achieving comfort. The literature documents pain is inadequately managed as a result of inadequate knowledge, attitudes, and potential barriers. Advanced prepared nurses (APNs) and physicians engage in professions that demand safeguarding and protecting the health of patients. APNs and physicians have an ethical duty to provide collaborative, interdisciplinary pain management to patients.
This study described the knowledge, attitudes, and perceived barriers of South Dakota APNs and physicians in regard to selected …

Persistent Oral Dyskinesias Induced By Long-Term Haloperidol Treatment Is Dissociated From Changes In Neostriatal B(Max) And Mrna Content For Dopamine D(2) Receptors, Nuoyu Huang

Electronic Theses and Dissertations

Due to the presumed associations of dopamine (DA) receptor supersensitivity phenomena in both long-term neuroleptic-treated tardive dyskinetic rats and neonatal 6-hydroxydopamine (n6-OHDA)-lesioned rats, we studied the influence of haloperidol on n6-OHDA-lesioned rats. At 3 days after birth rats received 6-OHDA-HBr (200 $\mu$g, bilateral intracerebroventricularly; desipramine pretreatment, 20 mg/kg, 1h) or vehicle. Two months later haloperidol (1.5/kg/day $\times$ 2 days/week for 4 weeks, then 1.5 mg/kg/day, every day for 10 months) was added to the drinking water. Spontaneous oral activity of intact and n6-OHDA-lesioned rats receiving haloperidol was reached and maintained at significantly higher levels after 15 weeks of haloperidol treatment. …

Moraxella (Branhamella) Catarrhalis: A Molecular Epidemiology Study, Lyndell R. Gill

Electronic Theses and Dissertations

Moraxella (Branhamella) catarrhalis is the third-most-frequently isolated microorganism associated with acute exacerbations of chronic bronchitis in patients during their stay at the Mountain Home VA Medical Center (MHVAMC). In order to develop a practical, epidemiologically-meaningful typing method for M. (B.) catarrhalis, we tested two methods based on analysis of chromosomal DNA for typeability, reproducibility, and ability to differentiate between unrelated strains (discriminatory power, D). M. (B.) catarrhalis isolants from MHVAMC from 7/1/87-6/30/88 were grown overnight in broth and embedded in agarose. DNA was isolated by standard methods. The DNA was subjected to: (1) restriction endonuclease digestion (with either Bgl II …

Indomethacin Reduces Splenic Red Pulp Macrophage Populations In Female New Zealand White Rabbits, Thane S. Thurmond

Electronic Theses and Dissertations

In an effort to elucidate the mechanism by which indomethacin (IN) attenuates the stimulatory effect of estradiol (E$\sb2$) on rabbit splenic red pulp macrophages (RPM), thirty-nine female New Zealand White rabbits were divided into 10 groups: ovariectomized (OVX), OVX/IN at 0.1 and 5.0 mg/kg body weight (bw)/day; sham OVX (SOVX), SOVX/IN at 0.1 and 5.0 mg/kg bw/day; OVX/25 mg E2, OVX/25 mg E$\sb2$/IN at 0.1 and 5.0 mg/kg bw/day; intact Control. Quantitative changes in RPM population in response to the treatments were measured using a 0 to 4 histologic grading scale. Estradiol treatment resulted in increased RPM grade when compared …

Cytokines And Ovulation In The Mouse Ovary, Jong G. Kim

Electronic Theses and Dissertations

Ovulation has been hypothesized as an inflammatory process. Interleukin(IL)-1$\alpha$, IL-1$\beta$ and tumor necrosis factor(TNF)-$\alpha$ are potent cytokines produced from macrophages and various other cell types, and are pivotal components of inflammation. Although previous studies have investigated cytokine activities in the reproductive system, there is little information on their precise localization and activities during the periovulatory period. To investigate the role of cytokines in ovulation, experiments were designed to determine the immunohistochemical localization and time specific production of cytokines IL-1 and TNF-$\alpha$ using a mouse model at 36h, 12h, 6h, 2h before ovulation, and at 6h and 18h after ovulation in …

Microcirculation: Electrophysiological Basis For The Response Of Endothelial Cells To Inflammatory Mediators-Bradykinin, Kai Miao

Electronic Theses and Dissertations

Using conventional microelectrodes, I studied the electrical basis for determining the resting V$\sb{\rm m}$ in intact EC's from hamsters. The resting V$\sb{\rm m}$ were found to be $-$40 mV for aortic EC's and $-$43 mV for vena caval EC's. The contributions of ions to the resting V$\sb{\rm m}$ of aortic EC's were compared in terms of the transference number (t$\sb{\rm ion}$). To develop a technique for in situ monitoring changes in V$\sb{\rm m}$ of postcapillary venular EC's in the hamster mesentery, a voltage-sensitive fluorescent probe, bisoxonol, was used to load the cells and the fluorescence signals were analyzed under an …