Medicine and Health Sciences Commons^™

Humeral Retroversion, Range Of Motion, And Strength Adaptations In Tennis Players, Daniel Hannah

Electronic Theses and Dissertations

Purpose: This study aimed to develop an understanding of humeral retroversion (HRV) asymmetries in tennis players and its impact on physical and performance characteristics of the shoulder.Participants: Healthy tennis players were categorized into 3 groups: younger juniors (n=11, age=14.5±0.5 years), older juniors (n=12, age=17.1±0.9 years), and collegiate (n=16, age=19.6±1.2 years). Methods: HRV, internal rotation (IR), and external rotation (ER), total arc of motion (TAM), HRV-corrected IR (HRVcIR), and HRV-corrected ER (HRVcER) were measured and calculated bilaterally using a digital inclinometer and ultrasonography. Bilateral differences (Δ) were calculated (dominant minus nondominant) for HRV and ROM variables. Isometric ER:IR strength ratios …

Dual Inhibition Of The Pi3k/Akt And Mek5/Erk5 Pathways For The Treatment Of Breast Cancer, Thomas Douglas Wright

Electronic Theses and Dissertations

Breast cancer is a heterogeneous disease state with several challenging frontiers. In particular, aberrations in the Phosphoinositide-3-kinase (PI3K) and Mitogen Activated Protein Kinase (MAPK) pathways have been linked to increased breast cancer proliferation and survival. It has been proposed that these survival characteristics are enhanced through compensatory signaling and crosstalk mechanisms. New evidence suggests that MEK5/ERK5, a member of the MAPK family, is a crucial component in the proliferation and survival of several aggressive cancers. We hypothesize that inhibiting both PI3K/Akt and MEK5/ERK5 pathways will decrease cell viability while maintaining limited collateral toxicity. In this study, we examined the effects …

Individual Eeg Asymmetry As A Predictor Of Hydration Status During Exercise In The Heat, Ayano Katayama

Electronic Theses and Dissertations

Hydration behavior varies among individuals; continuous and correct fluid consumption behavior prevents decreased physical performance and severe dehydration, especially during extended exercise and hot environments. Therefore, the purpose of the present study was to examine individual frontal alpha electroencephalographic asymmetry index (FAI) score in eu-hydrated, hypo-hydrated, and exercise in well-trained men and assess if there is a correlation between FAI score and individual ad libitum fluid consumption behavior. Subjects were kinesiology major college students ranging from 21 to 29 years of age. Subjects were categorized either approach group (n = 8) with resting FAI score more than 0 or avoidance …

Predicting Residency Match Outcomes For Fourth-Year Medical Students., Jacob Shreffler

Electronic Theses and Dissertations

An important goal for undergraduate medical education program leaders is to prepare their medical students to successfully match during the National Residency Match Program (Gauer & Jackson, 2017). Due to the recent increase in applications submitted during the residency process, it is critical for medical education programs to better understand the factors and attributes of those medical students who are successfully matching (Liang, Curtin, Signer, & Sawoia, 2017). As there is a larger number of medical students now enrolled than positions available for residency, the number of unmatched seniors is expected to rise (Bumsted, Schenider, & Deiorio, 2017). Additionally, the …

Characterizing The Role Of Extracellular Matrix In Non-Small Cell Lung Carcinoma Metastasis Using A 3d Microenvironment Mimetic In-Vitro Culture System., Douglas John Owulaku Saforo

Electronic Theses and Dissertations

Lung cancer is the leading cause of cancer related death in the United States and worldwide. Five-year survival rates for non-small cell lung carcinoma patients have not improved in decades, and a majority of patients succumb to metastasis. Identification of therapeutic targets for metastatic disease is essential for the development of novel therapies. However, current 2-dimensional (2D) in vitro models are not reflective of the tumor microenvironment (TME) and are inadequate in identifying therapeutic targets. We adapted a 3-dimensional (3D) extracellular matrix (ECM) in vitro model to a hypoxic incubator to approximate physiological hypoxia of the TME in a microenvironment …

A Distinct Pattern Of Sterile Inflammation Induced By Zinc Oxide Nanowires., Ruqaih Salem Alghsham

Electronic Theses and Dissertations

In recent years, there has been an increasing interest in nanotechnology. Engineered nanomaterials (ENMs) become an increasingly important area in nanotechnology. Recent developments in ENMs have drawn commercial and research attention in many areas such as agriculture, medicine, and Industry. High-aspect ratio zinc oxide nanowires (ZnONWs) have become one of the most significant ENMs due to their remarkable physical properties which makes them useful in a wide-range of applications. However, questions have been raised about ZnONW safety uses and biological consequences. In this dissertation, we investigated the inflammatory potential of ZnONWs in mouse models. C57BL/6 mice were exposed to ZnONW …

Probability Of Conception After Fertility Counseling And The Association Of Sexually Transmitted Infections With Pregnancy In The Loussi Study., Lindsey Adelle Wood

Electronic Theses and Dissertations

This study interrogated predictors of pregnancy and the effect of a history of sexually transmitted infection (STI) on probability of conception among a cohort of women seeking fertility counseling (N=170), using multivariable logistic regression and Cox proportional hazards models. There were 76 (44.7%) total pregnancies. 32 (39.0%) were achieved spontaneously by women who never received ART (N=82). Among women who did receive ART (N=88), 35 (39.7%) were achieved by ART and 9 (10.2%) achieved spontaneously. Among the full cohort (N=170), obesity was a significant negative predictor of pregnancy while history of human papilloma virus was a significant negative predictor of …

The Effect Of Spinal Cord Injury On Sexual Function., Casey J. Steadman

Electronic Theses and Dissertations

Spinal cord injury (SCI) causes severe neurological impairment with widespread motor, autonomic and sensory deficits, leading to a substantial quality of life impairment. The number of individuals with SCI increases by approximately 12,500 annually, and over 80% of individuals with SCI are males. SCI individuals rate sexual function as a top priority quality of life issue, and men with SCI likely suffer from sexual dysfunction, such as erectile and ejaculatory dysfunction, as well as infertility. Regardless of the high status of importance of sexual function, limited numbers of experimental studies in SCI animal models have focused on sexual function after …

Determining The Effect Of An Educational Intervention On Medical Support Personnel's Knowledge To Administer A Standardized Developmental Screening Tool., Leslie Chiaventone Lopez

Electronic Theses and Dissertations

Early treatment of developmental delays leads to improved outcomes for children (Yeung et al., 2014). In order to benefit from early intervention, children with developmental delays must be identified and referred at a young age. Although the use of validated developmental screening tools is supported by American Academy of Pediatrics (AAP) guidelines, these instruments are used variably by general physicians in pediatric practice (King et al., 2010). Because of the expanding work roles of medical support personnel, it is worthwhile to determine if this group can administer and score a developmental screening tool after completing an educational intervention to assist …

Exploring The Match Demands Of Division I Women’S Collegiate Soccer, Robert W. Sausaman

Electronic Theses and Dissertations

The purpose of this dissertation is to shed light on the physical demands of women’s soccer at the NCAA division I college level. Though research does exists describing the physical demands of women’s soccer, the vast majority seeks to explain the physical demands association with the professional and international level. This dissertation sought to: 1) examine the physical demands of NCAA division I women’s soccer and 2) observe changes in physical demands of two NCAA division I women’s soccer players over a four-year career using a case study approach.

Study 1 examined the physical demands of twenty-three athlete from a …

Non-Viral Transfection Efficiencies For The Advancement Of Car-T Therapy., Emily M Murphy

Electronic Theses and Dissertations

Leukemias are the most common form of childhood cancer making up 30% of total pediatric oncological cases, and Acute Lymphoblastic Leukemia (ALL) makes up a significant portion (12%) of the total pediatric cancer diagnoses. In 2017, the FDA approved a successful immunotherapy called CAR-T therapy for the treatment of pediatric B-cell ALL. This therapy includes a CAR (chimeric antigen receptor) that is loaded into the T-cell and expressed. Currently, the loading of the CAR utilizes viral transduction, but consistency issues lead to adverse symptoms in the patients. Better methods of transduction/transfection are being studied in order to improve these consistency …

The Salivary Alpha-Amylase Response To Resistance Training, Asher Flynn

Electronic Theses and Dissertations

The purposes of this dissertation were to investigate the response of salivary alpha-amylase to a single resistance training session and to a week-long resistance training over-reaching protocol. The major findings of this dissertation are as follows:

Study 1 – A single resistance training session consisting of 5 sets of 10 repetitions of squat and bench press at 95 percent of repetition maximum creates a statistically significant increase in salivary alpha-amylase concentrations.

Study 2 – Two resistance training sessions consisting of 5 sets of 10 repetitions of squat and bench press at 95 percent of repetition maximum within 5 days does …

Assessing Heat-Related Mortality And Morbidity Risks In Rural Populations And Sub-Populations, Emmanuel A. Odame

Electronic Theses and Dissertations

Heat stress is an environmental and occupational hazard exacerbated by climate change. Rural populations and sub-populations continue to experience disproportionate risks of heat-related impacts due to their low adaptive capacities in terms of infrastructure, information and other resources which are critical in dealing with heat. The study goals were to determine heat-related mortality risks in rural populations globally, explore the contribution of the outdoor work environment and other factors in association with occupational heat-related illnesses (HRI), and assess the risk of heat stress among crop workers using the Wet Bulb Globe Temperature (WBGT). Published peer-reviewed scientific literature on heat-related mortality …

Heat Waves And Heat-Related Mortality In East Tennessee, Taiwo Adesoba

Electronic Theses and Dissertations

Heat waves represent a public health challenge that requires multiple responses and warnings to protect vulnerable populations. Although studies have reported an increasing trend of heat wave occurrence in many areas of the world, no clear trend exists in East Tennessee. Using data from Parameter-elevated Relationships on Independent Slope Models (PRISM), CDC WONDER and the United States Census Bureau, the relationship between mortality rates and year was estimated during heat wave events between 1999 and 2010. Five heat wave definitions were tested. Overall, 2007 and 2010 stand out as the years with the highest number of heat wave days in …

Comparative Spending Of Medicaid Dollars On Child Participants Of Kentucky’S Sobriety Treatment And Recovery Teams Program Versus A Matched Comparison Group., Matthew Thomas Walton

Electronic Theses and Dissertations

Child protective services agencies have long observed the complicating role that parental substance use and addiction plays in cases of child maltreatment. Families who struggle with these problems present unique challenges for child welfare professionals. These families are typically more difficult to engage, more likely to have children removed from the home, and have poorer outcomes when compared to other families. These poorer outcomes often include health problems. Addiction has well-known effects on health, and the specific manifestations of these problems for parents have been documented for years in child protection casework. However, what has been less investigated are the …

The Influence Of Strength In Load-Velocity Relationships In The Back Squat, Thaddeus Light

Electronic Theses and Dissertations

Load-velocity relationships may vary between people of different strength levels and across different loads. The purpose of this dissertation was to investigate how external loads influence the velocity characteristics of the back squat exercise, and the influence of strength on these variables. Healthy male students with a history of resistance training completed repetitions at specified intensities of their estimated one-repetition maximum (1RM) until they reached 1RM. Back squat 3D motion analysis was captured using four Vicon T010 cameras (Vicon Motion Systems Ltd.; Oxford, UK) and Vicon Nexus 1.8.5 software. Data were transported into R custom coding statistical analysis software (version …

The Effects Of Branched Chained Amino Acid Supplementation On Acute Markers Of Fatigue And Performance, Joseph Walters

Electronic Theses and Dissertations

The purposes of this dissertation were to investigate the acute effects of branched-chain amino acids on psychological, physiological, and subsequent performance changes following high volume resistance training. The rationale for this study design was based on abrupt or contiguous training/ competitions that specific athletes encounter in a competitive season. This study design also sought to fill some gaps in the scientific literature concerning the efficacy of BCAAs for subjective fatigue in a resistance training paradigm. To address the purposes of this dissertation, a one-week study was conducted on resistance trained males, in which half of the subjects were randomly selected …

The Influence Of Chronic Branched-Chain Amino Acid Supplementation On Measures Of Central And Peripheral Fatigue In Training Athletes, Tara K. Whiton

Electronic Theses and Dissertations

Branched-chain amino acid (BCAA) supplementation may improve recovery from competitive endurance training by reducing symptoms of central and peripheral fatigue. The purpose of this dissertation was to provide evidence for the use of BCAAs as a training nutrition strategy in order to improve recovery from training and further drive adaptive processes to training by increasing readiness to train. Collegiate distance runners undergoing intense competitive endurance training were monitored for symptoms of muscular soreness and psychological stress through a rated soreness chart and the Daily Analysis of Life Demands for Athletes Survey (DALDA) while taking either a BCAA supplement or a …

Exploring The Role Of Social Capital In The Implementation Of Fruit And Vegetable Incentive Programs: A Case Study Of The Appalachian Farmacy Program, Kiriinya Mwirigi

Electronic Theses and Dissertations

The study was conducted to explore the role of social capital in the implementation of Fruit and Vegetable Incentive Programs (FVIP) through a case study of the Appalachian Farmacy (AF) program and to fill a gap in literature on social capital utility in the implementation and evaluation of FVIPs. The study was guided by a conceptual model adopted from Berkman et al. (2000) to identify the mechanisms through which social networks can impact health. A qualitative content analysis was conducted retrospectively on secondary data from the evaluation of AF program to identify social capital attributes. In addition, the study conducted …

Barbell Trajectory And Kinematics During Two International Weightlifting Championships, Aaron J. Cunanan

Electronic Theses and Dissertations

Several methods have been used in the scientific literature to study the weightlifting pull. Broadly, these methods are used to measure kinematic or kinetic variables exhibited by the lifter, the barbell, or the lifter-barbell system. However, there is an apparent disconnect between weightlifting research and coaching practice that may reduce the perceived benefits of technique analysis among coaches and present some challenges for coaches who seek to incorporate technique analysis into their coaching practice. Differences and trends in the technique of competitive weightlifting performances are apparent from the available literature. However, there are also gaps in the literature due to …

Impact Of Adverse Childhood Experiences On Mental Health Outcomes And Related Prescription Practices In A Psychiatric Inpatient Sample, Carrie Lemay

Electronic Theses and Dissertations

A definitive association between adverse childhood experiences (ACEs) and negative physical and mental health outcomes has been established. There is evidence that individuals in forensic psychiatric facilities are disproportionately exposed to ACEs, which may impact severity, prognosis, and age of onset of psychiatric symptoms, including behavioral concerns of institutional aggression, self-harm behaviors, and suicide attempts. Such psychiatric and behavioral concerns are often managed through multiple psychotropic prescriptions, leading to psychotropic polypharmacy. This study evaluated the relationship between ACEs, mental health and behavioral concerns, and psychotropic polypharmacy through analysis of archival data from a forensic inpatient psychiatric facility. A total of …

Neonatal Intensive Care Unit Speech-Language Pathologists’ Perceptions Of Infants With Neonatal Abstinence Syndrome, Lauren Fabrize

Electronic Theses and Dissertations

Objective: The purpose of this study was to determine the characteristics, assessment, and treatment of infants with Neonatal Abstinence Syndrome (NAS) as perceived by Speech-Language Pathologists (SLP) and whether it differed from those of other Neonatal Intensive Care Unit populations.

Methods: A secure web-based questionnaire with 62 questions collected information on NAS, caseloads, treatment environment, and demographics. Twenty-six respondents initiated the survey; 42% completed most or all questions. Response analyses included descriptive and nonparametric inferential statistics.

Results: Infants with NAS were on the caseloads of 73% of respondents. The majority (79%) only saw infants with NAS and feeding problems. Primary …

Contemporary Nursing In Rural Appalachia: A Hermeneutic Study, Evelyn Brewer

Electronic Theses and Dissertations

Nurses make up a significant source of direct care for individuals, families, and communities. The problematic distribution of nurses and the potential to lose practicing nurses emphasizes the importance of retention and support of nursing professionals, especially in rural locations. One of the best ways to discover what is important to nurses is to ask and listen to the replies.

The focus for this dissertation is the lived experience of registered nurses in a six-county area in three adjoining states in rural South Central Appalachia. The purpose of this study is to interpret and understand the lived experience of contemporary …

Effects Of Neuromuscular Fatigue Resulting From Repeat Sprint Exercise Among Trained Cyclists On Measures Of Strength And Power Performance, Robert B. Blaisdell

Electronic Theses and Dissertations

The purpose of this dissertation is to better understand the role of repeated-sprint ability (RSA) and resulting fatigue in cyclists; how it relates to measures of aerobic power and strength and power performance indices- due to the nature of cycling competitions and the necessity of RSA for success.

The first part of this dissertation attempted to elucidate the relationship between RSA and aerobic power and strength/ power measures in competitive cyclists. The purpose was to potentially illustrate the importance of the inclusion of strength and power training in the training regimen of cyclists. The findings showed several statistically significant relationships …

Changes In Psychological, Morphological, And Performance Characteristics In Preparation For A National Weightlifting Competition, Donald Marsh

Electronic Theses and Dissertations

The primary aim of this study was to examine the time course of change in muscle morphology and vertical jump performance in weightlifters preparing for a national competition. The secondary aim of this study is to examine how perceived recovery and stress state corresponds with alterations in training load leading up to competition. Eleven Olympic Training Site weightlifters completed a 4-week peaking phase for a national competition. Body mass, stress and recovery psychometric measures, and unloaded/loaded (20kg) squat jump height (SJH) were measured weekly and at the competition site. Vastus lateralis cross-sectional area (CSA), muscle thickness (MT) and pennation angle …

Comprehensive Staff Education And Implementation Of A Checklist Tool To Increase Staff Adherence To Pitocin Titration Protocols, Tara N. Cassell

Electronic Theses and Dissertations

This quality improvement project was designed to increase staff adherence to an existing Pitocin titration protocol used in a labor and delivery unit at a community hospital. In the current U.S. health care climate, safe patient care is paramount and the Institute for Safe Medication Practices identified Pitocin as a high-alert medication. Evidence-based practice recommends the use of a titration protocol to guide proper use of Pitocin. Prior research has shown improvements in patient outcomes when facilities implement Pitocin titration protocols, with staff adherence key to the successful implementation of evidence-based titration protocols, which may be improved with the use …

Arachidin 3 Modulation Of Lipid Metabolism In Rotavirus Infections, Stormey Wisdom

Electronic Theses and Dissertations

Rotavirus (RV) can cause severe and deadly gastroenteritis in young children, infants, and immunocompromised individuals. Previous studies have shown that arachidin 3 (A3) inhibits RV replication, and that RV replication is dependent on the presence of lipids. This study investigated the alteration of lipid metabolism by A3 in RV infected HT29.f8 cells. A decrease in the RV regulation of lipid biosynthesis genes was observed with the addition of A3 using qRT-PCR. Also, immunofluorescent and histochemical staining for neutral fats, a major component of cellular lipid droplets, revealed an increased accumulation with both RV and RV+A3 when compared to no virus …

Developing Resilience Training For The Healthcare Employee In A Rural Medical Center, Sandra E. Gothard

Electronic Theses and Dissertations

In the clinical setting and in their personal lives, health professionals are confronted with many stressors that impact their time and the clarity of their role. Stressors are emotional, moral, or spiritual in nature as a result of exposure to suffering and death. There are often occupational stressors, such as reduced social support, excessive workload, or a prolonged misalignment among personal needs, individual values, and the work role. As a result of these challenges, health care employees need to create coping skills when stressors and demands become hindrances to personal well-being and their professional ability to care for others. Developing …

Use Of A Communication Tool To Improve The Perception Of Continuity Of Care, Annette Lotz

Electronic Theses and Dissertations

Inadequate or incorrect communication during transfer from skilled nursing facilities leads to misunderstandings about patient care needs, jeopardizes patients’ trust in the health care system, and leads to poor clinical outcomes. Due to gaps in communication from one health care setting to another, it was essential to determine if a patient-centered discharge tool would improve patients’ perception of continuity of care. The purpose of the study was to implement a patient-centered tool that would help improve the information needed at the time of discharge from a skilled nursing facility. Roy’s Adaptation Model supports the relevance of effective communication in the …

Analysis Of Tobacco Use Vital Sign Assessment, Latonya King

Electronic Theses and Dissertations

There is a massive problem of tobacco-related cancer outcomes in patients that are affected by race and ethnicity. Although this is a known disparity, there continues to be a gap in care for asking patients if they use tobacco and in advising and assisting them in making a quit attempt. Health information technology requirements and meaningful use regulations require the utilization of systematic electronic documentation. In order to improve and support tobacco use screening, systematic tobacco use assessment and documentation are essential. There is a widespread belief that adding screening for tobacco use to the vital sign assessment will lead …