Medicine and Health Sciences Commons^™

Exploring The Contextual Factors And Decision-Making Process Of Risky Sexual Behavior Among Homeless Adults In Louisville, Kentucky., Sarah C. Van Heiden

Electronic Theses and Dissertations

Homelessness is a complex public health issue; individuals who experience homelessness are said to engage in risky sexual behaviors at an increased rate and experience a higher prevalence of sexually transmitted infection (STI). While the sexual behaviors of homeless adolescents are commonly studied, little is known about the sexual behaviors of the growing population of older adults, or how they make decisions to engage in sex. Three aims guided this research: 1) to describe the sexual behaviors and sexual decision-making process of homeless older adults, 2) to examine how homeless older adults evaluate the outcomes associated with engaging in risky …

The Association Between Depression And Anxiety With Covid-19 Outcomes., Erica Miller

Electronic Theses and Dissertations

Previous studies have shown that mental disorders affect COVID-19 mortality. This study investigated the effect of depression and/or anxiety on COVID-19 outcomes. Depression/anxiety was defined by actively taking medication and/or diagnosis. The outcomes were ICU admission; ventilation; mortality; and time to mortality. Of 698 hospitalized patients, there were 204 (29%) defined to have either depression or anxiety. There were 109 deaths, and of those, 52 (48%) were diagnosed with depression/anxiety. Multivariable logistic regression and Cox proportional hazards models were used to examine associations. ICU admission and ventilation were not significantly associated with depression/anxiety. Depression/anxiety was associated with mortality (OR: 1.84, …

Role Of Ataxia Telangiectasia Mutated Kinase In Western-Type Diet-Induced Cardiac Outcomes Under Basal And Ischemic Conditions, Mary Wingard

Electronic Theses and Dissertations

Ataxia-telangiectasia mutated kinase (ATM), a serine/threonine kinase, plays a role in DNA damage repair, redox sensing, and metabolism. In the heart, ATM contributes significantly in the myocardial infarction (MI)-induced cardiac remodeling with effects on fibrosis, hypertrophy, apoptosis and inflammation. This study investigates the role of ATM deficiency in 14 weeks Western-type diet (WD)-induced cardiac outcomes prior to and 1-day post-MI in a sex-specific manner using wild-type (WT) and ATM heterozygous knockout (hKO) mice. In male mice, ATM deficiency induced rapid body weight gain and preload-associated dysfunction, while WT mice displayed afterload-associated dysfunction 14 weeks post-WD. Myocyte apoptosis and hypertrophy were …

Peer Recovery Support Specialists: Role Clarification And Fit Within The Recovery Ecosystems Of Central Appalachia, Angela Hagaman

Electronic Theses and Dissertations

The Peer Recovery Support Specialist (PRSS), a certified professional who self-identifies as being in recovery from a substance use disorder (SUD), mental illness, or co-occurring disorders, plays a key role in the ongoing transformation of SUD treatment from one of acute clinical service provision with documented short-term outcomes including symptom reduction, to a more holistic and comprehensive approach to long-term recovery. Empirical evidence specific to outcomes of PRSS working in the addiction treatment realm is sparse and equivocal, indicating the need for additional research and improved methods designed to explore the nature of the PRSS role and fit within the …

Genital Chlamydia Infection Is Influenced By The Female Sex Hormones Estrogen And Progesterone In Vivo, Amy Gail Gravitte

Electronic Theses and Dissertations

Chlamydia is the most common bacterial sexually transmitted infection in the United States and worldwide. It often goes unnoticed due to lack of symptoms and left untreated it can ascend the female genital tract to cause sequelae like pelvic inflammatory disease and irreversible tubal infertility. In reproductive-aged women, female sex hormones estrogen (E2) and progesterone (P4) concentrations fluctuate during the menstrual cycle and are influenced by hormonal contraceptives and hormone replacement therapy. E2 and P4 influence genital Chlamydia infection in women and mice, but these multifactorial interactions are not entirely mapped out. The complex interplay of E2 and P4 with …

Comparing Different Scaling Methods For Monitoring Weightlifting Performance, Jake Slaton

Electronic Theses and Dissertations

Physiological performance has been commonly scaled for body size using various methods to scale anthropometrics, but a paucity of data exists on scaling muscle size. The aim of this thesis was to elucidate the optimal method to scale height (HT), body mass (BM), lean body mass (LBM), and muscle cross-sectional area (CSA) when scaling weightlifting performance for body size. 26 weightlifters (13 male, 13 female) participated in this study. The measurements collected were the snatch (SN), clean and jerk (CJ), isometric peak force (IPF), and countermovement jump height (CMJH). HT, LBM, BM, and vastus lateralis CSA were scaled using the …

Stress And Anxiety Experience Of Dental Hygiene Students, Kristen Ford

Electronic Theses and Dissertations

The ETSU dental hygiene program is very competitive and rigorous for those admitted. Student dental hygienists may experience higher levels of anxiety and more stressors while completing their course work and clinical hours than they have previously experienced in general education and prerequisite courses. These increased number of stressors and higher levels of anxiety may have negative impacts on students’ academic performance and success in clinical learning environments. A better understanding of the actual need for a stress reduction and anxiety management curriculum will facilitate creating and implementing this type of curriculum. A total of 44 current ETSU dental hygiene …

Hospital-Based Professional Spiritual Care: Evaluating The Utilization, Availability, And Impact Of Chaplains., Kelsey B. White

Electronic Theses and Dissertations

BACKGROUND: The Affordable Care Act, enacted in 2010, transformed healthcare policy and forced hospitals to reevaluate traditional methods for care delivery. Researcher advocated for patient-centered models of care to reduce costs, address inequitable access to services, and improve service quality. These models prioritize patient values, preferences, and beliefs inclusive of patients’ religious and spiritual needs. Professional chaplains provide religious and spiritual care within many hospital settings. This dissertation explored the characteristics of hospitalized persons using chaplains, the factors associated with a hospital reporting a chaplaincy department, and how those services impacted patient satisfaction. METHODS: The first analysis used a two-part …

Effects Of Chemosensory Experience And Context On Consummatory Behaviors., Saphira M. Chiu

Electronic Theses and Dissertations

Eating food generates associations between odors and tastes (i.e., flavor) that guide future choices. Experience with an odor-taste mixture links an odor with a taste’s quality and hedonic value, resulting in a preference for an odor paired with a palatable taste over an odor paired with an unpalatable taste. However, experience with a neutral stimulus (i.e., latent inhibition) or environment (i.e., context) can influence the formation of conditioned associations. Here, I used a two-bottle brief-access task to determine whether rats display an innate preference between unpaired odors (isoamyl acetate and benzaldehyde), how preexposure to the unpaired odors impacts mixture-dependent consummatory …

Collaborative Human-Machine Interfaces For Mobile Manipulators., Shamsudeen Olawale Abubakar

Electronic Theses and Dissertations

The use of mobile manipulators in service industries as both agents in physical Human Robot Interaction (pHRI) and for social interactions has been on the increase in recent times due to necessities like compensating for workforce shortages and enabling safer and more efficient operations amongst other reasons. Collaborative robots, or co-bots, are robots that are developed for use with human interaction through direct contact or close proximity in a shared space with the human users. The work presented in this dissertation focuses on the design, implementation and analysis of components for the next-generation collaborative human machine interfaces (CHMI) needed for …

Exploring Integration Between Athletic Trainers And Strength And Conditioning Coaches Among The Ncaa Division I Southern Conference Institutions, Yoshihiro Kojima

Electronic Theses and Dissertations

The purpose of this study was to explore the interdepartmental integration between athletic trainers and strength and conditioning coaches in relation to relationship, communication, collaboration, and education. Forty participants from the NCAA Division I Southern Conference, twenty-eight athletic trainers and twelve strength and conditioning coaches, completed an electronic survey during a two-week period. Collected data were analyzed by descriptive and thematic coding analyses. The results suggested participated athletic trainers and strength and conditioning coaches were interactive and collaborative. Open-ended responses identified key concepts when athletic trainers and strength and conditioning coaches communicated and collaborated. A high interaction and collaboration model …

Nursing Perceptions For Utilizing Essential Oil Application In Labor And The Effect Of Targeted Education, Joni R. Beckham

Electronic Theses and Dissertations

This Doctor of Nursing Practice project was implemented to determine how a nurse’s perception of aromatherapy influences their decision to provide aromatherapy for patients during labor and the effect of targeted education on a nurse’s perception. The purpose of this project was to determine how nurses view the use of aromatherapy resources at their disposal and the likelihood that they would offer the intervention to their patients. This project provided education to increase nurses’ confidence in providing optimal care to patients using a traditional and holistic avenue of aromatherapy while determining if education can positively influence nurses to support essential …

Implementing Mindfulness Meditation To Reduce Nurse Burnout, Jannelle V. Sanchez

Electronic Theses and Dissertations

Abstract

There will be an estimated shortage of 100,000 nurses by the year 2022, with 500,000 seasoned nurses retiring. The nursing profession has recently experienced a devastating pandemic that left no time to combat the detrimental effects of burnout, specifically for intensive care nurses, who are the frontline workers of a physically and psychologically draining working environment conducive to burnout. Nurses experience burnout for a mixture of reasons, but mainly it is due to the lack of interventions to help them combat the disease. Mindfulness meditation represents an interventional tool that has been shown to reduce the negative stressors associated …

School Nursing Practice And Experiences During School Closures, Susie E. Birden Brown

Electronic Theses and Dissertations

This evidence-based quality improvement project was to evaluate public school nurses’ relationships and reaction to their new work environment during the closure of schools in Northern California resulting from the COVID-19 pandemic. This project addressed the change in school nursing, especially the nurses’ working environment. A stress management program was offered to the school nurses as an intervention to give them information on perceived stress. The stress management program included mindfulness and stress-relieving techniques over a 1-month period. The research methodology used in the project was a pre- and postintervention using the Perceived Stress Scale-10 (PSS) to measure if the …

Reducing The Potential For Physical Harm In Student Nurses Caring For Clients Who Are Under The Influence, Hunter William Halford

Electronic Theses and Dissertations

This DNP project was conducted to identify gaps in knowledge and adequate preparation of nursing students in safely caring for a client who is behaving violently and is under the influence of illicit drugs. Student nurses are trained using a generalist approach, meaning they are taught the essentials of a variety of topics. It is not until these students enter the workforce that they are trained specifically for a certain position. Currently, the curriculum does not address specific measures to maintain client and personal safety. It is an almost unavoidable fact that a nurse will encounter a violent client or …

Opioid Use Disorder: A Crisis Of Concern, Evangella Harville

Electronic Theses and Dissertations

According to a statement from the U.S. Centers for Disease Control and Prevention, between 2000 and 2017, approximately 700,000 people died from drug overdoses in the United States. Approximately 128 persons lose their life each day from an opioid overdose. The data for this study were collected by the vice president of operations at the study site from a preexisting database for 2019 and 2020. The participants were inpatient patients, 18 and older, both male and female, and were from all ethnicities. The study facility was located in Western New York and offered a 30-bed inpatient treatment center with 24-hour …

Addressing The Psychosocial State Of High-Risk Individuals Undergoing Hereditary Cancer Screening By Advanced Practice Registered Nurses (Aprns) In The Community Oncology Setting, Aquilina Kerubo Thompson

Electronic Theses and Dissertations

Abstract

Neoteric advances in genetics make it possible to define genetic risk in cancer, and there should be methods in place to provide comprehensive genomic care with oncology advanced practice registered nurses bridging this gap. The current scope of nursing practice stipulates genetic and genomic literacy; however, there remains a deficit among advanced practice registered nurses in identifying and addressing psychosocial distress during the genetic cancer risk assessment process. Oncology advanced practice registered nurses must be equipped with the knowledge that the genetic cancer risk assessment also involves protecting patients from the psychosocial repercussions of carrying a hereditary cancer gene …

Improving Sexually Transmitted Infection Knowledge In Community College Students: A Path To Prevention, Rebecca F. Halford

Electronic Theses and Dissertations

This DNP project was conducted to identify gaps in knowledge focusing on sexually transmitted infections within Texas and Region one. The research study gathered data from first-year nursing students who have chosen to participate in a sexually transmitted infection-focused educational module. Participants were first-year nursing students and understood the research study was strictly voluntary with no forms of compensation. Currently, the curriculum in the nursing program at which the study took place does not focus on sexually transmitted infections and is directed to speak minimally on the subject. This is a contributing factor to why the rise in sexually transmitted …

Education Of Nurses On The Use Of The Interact Tool, Daniyele L. Feaster

Electronic Theses and Dissertations

Abstract

Research reveals long-term care facilities face challenges with unnecessary transfers to acute care facilities. Use of the INTERACT quality improvement program has been effective in decreasing rehospitalizations in long-term care facilities. The researcher used a 15-question survey regarding the components of the INTERACT tool to assess the knowledge base of licensed nurses in long-term care facilities and develop a one-hour education session to bridge the knowledge gap. After the education session was held, a posttest was administered to test the licensed nurses’ knowledge of the INTERACT program. Using a paired-samples t test, the researcher found an overall increase in …

The Effect Of Postpartum Depression Screening Education For Postpartum Nurses, Shecarra S. Cook

Electronic Theses and Dissertations

Depression affects about 13% of pregnant women and about 10% of women after childbirth. Some cases are so severe, the mother may even commit suicide. If left untreated, postpartum depression (PPD) affects both the mother’s and the infant’s health as well as their quality of life. The gap in clinical practice is that currently, patients only complete a postpartum depression screening tool during their 6-week follow-up appointment with their OB/GYN, leaving a gap in PPD detection and care during the immediate postpartum period. Postpartum nurses are not usually given specialized training in postpartum depression. The purpose of this study was …

Reducing Parental Stress In Neonatal And Pediatric Intensive Care Units, Nancy M. Abbene

Electronic Theses and Dissertations

Abstract

The neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU) are highly operational and highly active environments. Health care workers must react quickly to care for patients and provide life-saving measures fundamental to favorable patient outcomes. Caregivers of this critical patient population are often overlooked as the healthcare team prioritizes patient’s needs. In addition, medical equipment, machines, and monitors have multiple safety alarms sounding frequently and contributing to high levels of parental stress upon their child’s admission to the NICU and PICU. Lack of giving adequate prominence to the value of caregiver support services in the hospital …

Decreasing Unintentional Pregnancies For Tennesseans, Paula M. Todd

Electronic Theses and Dissertations

In 2018, 49% of all pregnancies in the United States were unintended, with women with a lower- income status being five times more likely to experience an unplanned pregnancy. Tennessee has a high rate of unintended pregnancies, particularly among the uninsured, low-income, and rural teen populations; some 22% of these unintended pregnancies end in abortion. Oral or transdermal contraceptives that are affordable and accessible for women of childbearing age can reduce unintentional pregnancies. The addressed gap in clinical practice was that contraceptives are not currently available over the counter in Tennessee pharmacies without a prescription, which necessitates a costly medical …

An Evaluation Of An Integrated Multidisciplinary Early Identification And Triage Of College Students At Risk For Anxiety And Depression, Sarah J. Templeton

Electronic Theses and Dissertations

College students across the U.S. are experiencing an increasing prevalence of mental health concerns, such as anxiety and depression. Suicide is currently the second most common cause of death among U.S. college students. At the project site, the university health services report that mental health issues significantly impact the students’ academic progress, contributing to poor performance, inability to complete assignments, and sometimes forces attrition. Campus providers traditionally respond when students approach, often at the point of crisis or exacerbation. This Doctor of Nursing Practice (DNP) project evaluated the impact of a pilot program using an interdisciplinary approach to universal proactive …

Food Addiction And Obesity, Lisa Ling

Electronic Theses and Dissertations

The obesity rate in the U.S. adult population has increased to epidemic levels despite attempts to decrease obesity through evidence-based knowledge, clinical practice guidelines, medical interventions, and individual efforts. For certain individuals, food addiction behaviors such as food cravings, loss of control, and binge eating contribute to obesity and require a different approach to care. Little work has been done on adding the possibility of food addiction to obesity screening and treatment. This study utilized a quasi-experimental quantitative pre- and postsurvey research design based on Lewin’s change theory. Nurse practitioners were surveyed regarding the provider’s perceptions, attitudes, and beliefs about …

Exploring And Understanding The Culture Of Young Adults Who Vape: A Focused Ethnography, Beth Tremblay

Electronic Theses and Dissertations

Introduction: Vaping, the act of inhaling an aerosolized liquid, is associated with health risks. The 18- to 25-year-old age group has the highest rate of vaping among adults. Understanding culturally held values, beliefs, and experiences associated with the behavior of vaping in young adults may uncover the social mechanisms that underpin vaping initiation and influence continued use. The purpose of this study was to explore and understand the cultural values and beliefs about vaping among young adults. Method: The method used for this study was a focused ethnography. Young adults who currently vape nicotine (N=24) were recruited via snowball method …

Development Of A Combined Feedforward-Feedback Quality Control System For Extended-Release Granules Using A Quality By Design Approach, Yuxiang Zhao

Electronic Theses and Dissertations

Objectives

For a fluid bed film coating process to consistently deliver quality products, its control system needs to be robust against the variability of input materials and environmental disturbances. Presently, limited studies have been reported to understand the effects and interactions of the material attributes, environmental variables, and process parameters on the product in vitro drug dissolution. A control system can be developed with a proper understanding of the coating process, by adjusting the process parameters in feedback and feedforward manners to compensate for the undesired effect caused by disturbances, and ensure consistent product quality.

Methods

The control system was …

Deception Of Resistance And The Effects On Muscular Fitness And Perceived Exertion, Tyler Mchenry

Electronic Theses and Dissertations

Resistance training has been a popular tactic that individuals have used to increase muscular fitness for decades. Muscular fitness includes muscular endurance, strength, and power. However, limitations such as self-efficacy and the Central Governor Theory may influence individual maximal performance ability. One training tactic that has been rarely researched is the deception of resistance during exercise, which is assumed to increase performances in all aspects of muscular fitness and improvements in perceived effort. Inconsistent results have been concluded from previous studies that have examined the same topic. Therefore, the purpose of this study was to investigate the effect of resistance …

Patient Portal Use, Health Information Technology Self-Efficacy, Electronic Health Literacy, And Self-Management Among Patients With Heart Failure: A Cross Sectional Study, Pamel Kallmerten

Electronic Theses and Dissertations

Background: By the year 2030, the prevalence of heart failure (HF) is anticipated to rise by 46%, impacting over 8 billion persons. Self-management of HF is key to maintaining a healthy lifestyle and quality of life. Yet many have sub-optimal self-management skills necessitating innovative strategies to enhance self-management. An innovative strategy to support the person with HF is the use of health information technology (HIT) such as a patient portal (PP). Additionally, self-efficacy and health literacy are important to self-management of HF. Further understanding is needed of the relationship between PP use, HIT self-efficacy (HIT SE), electronic health literacy …

The Role Of Mek1/2 And Mek5 In Melatonin-Mediated Actions On Osteoblasts And Osteoclasts Differentiation, Bone Formation, Bone Microarchitecture, And Bone Biomechanics, Fahima Akter Munmun

Electronic Theses and Dissertations

Melatonin, the main endogenous hormone to entrain the circadian system, is not limited to its role in regulating the sleep-wake cycle; rather, it affects a wide variety of systems involving antioxidant, anti-inflammation, blood pressure regulation, seasonal reproduction, ovarian physiology, and immune function. Driven by the diversity of its action, melatonin for a long time has also been studied in the field of bone and mineral research both clinically and pre-clinically. Exogenous administration of melatonin in clinical trials in perimenopausal women (MOPS; NCT01152580); or postmenopausal women with osteopenia (MelaOST; NCT01690000 and MOTS; NCT01870115) confirmed improvement of bone mineral density (BMD) (MelaOST; …

Towards A "Universal Chemical Biology Toolbox" For Tackling Human Diseases, Christopher Swank

Electronic Theses and Dissertations

A lack of new drug targets and drug mechanisms, coupled with drug-pipeline attrition, represent significant problems in oncology drug discovery. Towards addressing this challenge, “fully-functionalized small-molecule probes” (FFSMPs) have been established, which are compounds that can be immediately used as “bait” to capture their protein targets under the same assay conditions used for oncology-based phenotypic screening. Specifically, each FFSMP library member contains one or more structural-diversity elements to promote interactions of the probe with different protein targets in living cells, an electrophile or photoreactive functional group for covalent attachment of the probe to interacting proteins via affinity or photoaffinity labeling, …