Medicine and Health Sciences Commons^™

A Potential Klebsiella Bacteriocin With Efficacy Toward The Enterbacteriaceae Family, Kasey Barber

Undergraduate Honors Theses

Drug resistance is unfortunately becoming a prevalent issue in the course of patient treatment, ranging from chemotherapy resistance to antimicrobial resistance. The Centers for Disease Control and Prevention (CDC) estimated in 2016 that at least 23,000 people die every year in the United States from an infection with an antibiotic-resistant organism (Munita, et al, 2016). Carl Friedlander was the first scientist to describe Klebsiella pneumoniae in 1882 as an encapsulated bacillus after isolating the bacterium from the lungs of patients who had died from pneumonia (Ashurst and Dawson, 2022). Klebsiella pneumoniae is the type species for the Klebsiella genus and …

Validity And Test-Retest Reliability Of A Digital Dynamic Visual Acuity Test Of Vestibular Function, Lydia F. Grunstra, Courtney D. Hall, Kara D. Stressman

Undergraduate Honors Theses

The vestibular system senses head motion and facilitates gaze stabilization, allowing for clear vision during movement. The vestibulo-ocular reflex (VOR) causes the eyes to move opposite head motion, thus maintaining focus on a target. Consequently, uncompensated loss of vestibular function leads to reduced VOR function resulting in dizziness, nausea, and visual disturbance. Different testing methods have been developed to measure VOR loss. These tests generally require bulky, expensive equipment, and must be performed by a trained examiner. A newly developed digital form of the dynamic visual acuity (DVA) test requires less equipment, is cost-effective, and may be performed at home …

Nonmedical Stimulant Use In An Undergraduate College Student Sample: Demographics, Academics, Stress, And Other Substance Use, Ashley Skye Vanover, Meredith K. Ginley, Shelby Whalan

Undergraduate Honors Theses

Nonmedical use of prescription stimuluants (NMUS) can cause adverse outcomes for college students including academic impediments, such as a lowered GPA, and polyuse of illicit substances (Garcia et al., 2021; Holt & McCarthy, 2019; Norman & Ford, 2018). The current study investigated the demographics, academics, stress, and polysubstance use between students who endorsed NMUS and those who did not in an undergraduate college population sample at a large public university in the Southeast. The sample consisted of 429 undergraduate students who completed online measures of demographics, perceived stress, stressful life events, and substance use. Overall, 3.4% of the sample reported …

Nicotinamide Riboside And Beta-Hydroxybutyrate Activate Parallel Pathways For C. Elegans Lifespan Extension, Mckenzie Peters

Undergraduate Honors Theses

Supplementation with nicotinamide riboside (NR), a form of vitamin B3 and a precursor of nicotinamide adenine dinucleotide (NAD⁺) extends lifespan in the nematode C. elegans and delays aging-related pathologies in mammals. During aging, levels of NAD⁺ decline causing metabolic dysfunction and oxidative damage. Studies in C. elegans found that when NR was administered during larval development it induced the mitochondrial unfolded protein response (UPR^mt), which is frequently associated with lifespan extension. Both calorie restriction (CR) and ketogenic diets (KD) have been shown to extend lifespan, in part through increasing NAD⁺ and through increasing levels …

Sexual Dimorphism Of Glomerular Capillary Morphology In Rats, Zackarias Coker

Undergraduate Honors Theses

Chronic kidney disease (CKD) progresses faster in males than females; however, the underlying mechanisms remain poorly understood. Sex differences in glomerular capillary morphology has been hypothesized to contribute, in part, to the increased susceptibility to hypertension-induced renal injury and CKD progression in males, but this has not been investigated. The goal of the present study was to assess glomerular capillary morphology in male vs. female rats with intact kidneys and after uninephrectomy (UNX). We hypothesized that glomerular capillary radii (R_CAP) and length (L_CAP) would be greater in male rats.

Male (n=4) and female (n=4) with intact …

Type 1 Diabetes In The Classroom, Ursula Herrell

Undergraduate Honors Theses

Type 1 diabetes [T1D] is an autoimmune disease that presents in a pathophysiological disorder as insulin deficiency. Managing this illness during childhood is a constant challenge of maintaining blood glucose levels within a healthy range, resulting in increased stress for children and caregivers. School attendance is one factor that may result in increased stress. Studies have highlighted the fact that teachers of students with T1D may receive little education regarding management of the disease and may be required to make accommodations which can result in confusion, miscommunication, and increased psychosocial stress. The goal of this research was to learn about …

Determining The Effects Of Maternal Adiposity On Preterm Neonatal Microbiome And Short Chain Fatty Acid Profiles, Dalton James, William A. Clark Phd, Kristy L. Thomas

Undergraduate Honors Theses

The gut microbiota and its metabolites have vast impacts on the human digestive system, immune system, and health outcomes. Short chain volatile fatty acids (SCVFAs) present in feces can be representative of the interactions of the microbiota present in the gut. Low microbiota diversity in the human gut is highly associated with obesity and adverse health outcomes. Furthermore, the maternal microbiome has a direct impact on neonatal microbiota through various pathways such as environment, skin flora, breast milk composition, and vaginal secretions. This study is aimed to further understand the associations between various factors (maternal adiposity, gestational time, length of …

Nutrition Needs Assessment For Women Of Childbearing Age With Polycystic Ovarian Syndrome, Callie Coleman, Whitney Bignell

Undergraduate Honors Theses

Polycystic Ovarian Syndrome (PCOS) is an endocrine disorder that affects women’s menstrual cycles, androgen (male hormones) levels, and cysts on the ovaries. This endocrine disorder has various symptoms, with insulin resistance as a hallmark symptom. Approximately 65-70% of women with PCOS have insulin resistance and hyperinsulinemia, whether or not they are overweight, obese, or lean (Marshall & Dunaif, 2012). Many women with PCOS struggle to lose weight because their excess weight is related to nutrition, lifestyle factors, and imbalanced hormones. Understanding PCOS as a metabolic disorder with nutritional implications led to investigating the potential benefit of having registered dietitian nutritionists …

An Examination Of The Impact Of Covid-19 On The Job Satisfaction And Emotional Well-Being Of Icu Nurses, Laura Ruth Daffron

Undergraduate Honors Theses

Healthcare systems have been demonstrably altered because of the COVID-19 pandemic. Resources were stretched and patient conditions deteriorated on a scale previously unseen, leaving nurses at the forefront to face the adversities brought about by the pandemic. In this study, a questionnaire was utilized to better understand how COVID-19 has impacted the stress level, resilience/well-being, moral distress, job satisfaction/enjoyment, practice environment, and intent to remain in the nursing profession of nursing alums from East Tennessee State University. This study focused on a subset of nurses working in critical care, to consider the impact that the pandemic had on ICU nurses’ …

Justification And Compliance: Public Health Ethics In A Post-Covid America, Nathan Alan Turner

Undergraduate Honors Theses

The severity of the COVID-19 pandemic and the high-profile nature of the public health response make it a natural context for exploring the current state of public health ethics. This paper explores this topic from two perspectives: justification and compliance. Libertarianism and utilitarianism are two frameworks that dominate the question of how public health interventions are justified. Consequently, this paper analyzes the events of the pandemic to determine how these frameworks fared in terms of offering reliable means of justifying the interventions needed to curb the spread of COVID-19. Consideration of these events suggests that a framework centered around actionable …

A Tri-Culture Model For Examining Polymicrobial Interactions, Mason Stanley

Undergraduate Honors Theses

Candida albicans is a fungal microbe that is often present inside of humans in the mouth and gastrointestinal tract. It shares a mostly commensal relationship with its hosts but can develop into an opportunistic pathogenic infection under conditions of immune suppression. Oral thrush or candidiasis is an uncomfortable condition resulting from excessive growth of Candida albicans in the oral cavity. Candidiasis is prone to progressing into more threatening symptoms without proper treatment. There are few effective antifungal medicines used for treatment and the problem of antimicrobial resistance is growing. Alcaligenes faecalis is a bacterial microbe that does not pose a …

Review Of Effective Injury Preventing And Performance Enhancing Strategies For Runners, Jessica Dolinger

Undergraduate Honors Theses

The purpose of this research is to piece together proven techniques for injury prevention and rehabilitation in runners and use this information to outline the best techniques to make invulnerable the body of a runner and maximally enhance his or her performance. This review will cover the specific muscles that, when strengthened or stretched, are closest linked to improved performance when running. Furthermore, shared characteristics of specific running injuries will be made, as well as examinations of debates for effective running injury rehabilitation strategies. By doing this, an understanding of running related injuries, and the studied exercises and techniques that …

A Survey To Highlight Areas Of Focus For Patient Care In Settings Utilizing Medical Interpretation, Azayzel Deregis

Undergraduate Honors Theses

This thesis recounts my personal experience working as a volunteer medical interpreter for the Language and Culture Resource Center at East Tennessee State University. The result of my time spent volunteering as a medical interpreter, shadowing professional medical interpreters, and witnessing patient-provider interactions during interpreted sessions was an inspiration to study medical interpretation further and delve into the challenges faced by patients who require medical interpreters. During my time researching this topic, I found that the United States is severely lacking in Spanish medical interpreters—with some healthcare facilities employing no medical interpreters—even though the size of the Hispanic population is …

Cyclic-Di-Gmp-Binding Proteins Regulate Acinetobacter Baumannii Motility, Gabriel Smith

Undergraduate Honors Theses

Acinetobacter baumannii is a prevalent nosocomial pathogen where, like many other infectious bacteria, A. baumannii is increasingly considered a multi-drug resistant pathogen. This research study was designed to find a way to affect the persistence of A. baumannii such that it can be applied to a hospital setting to prevent further nosocomial infections. One regulatory mechanism potentially used by A. baumannii to persist on hospital surfaces is through the use of the bacterial second messenger cyclic-di-GMP (c-di-GMP). This nucleotide signal is regulated in response to environmental conditions, and then activates c-di-GMP-binding proteins that induce phenotypic changes. One c-di-GMP-regulated phenotype is …

The Impact Of Covid-19 On The Opioid Epidemic, Hailey Stewart

Undergraduate Honors Theses

The COVID-19 pandemic adversely affected the lives of most Americans. People with Substance Use Disorder (SUD) were particularly vulnerable to the negative effects brought on by the pandemic. This study explored the increase in deaths due to opioid overdose during the pandemic exacerbated by factors such as increased stress, decrease in treatment options due to social distancing requirements and facility closures, social isolation, and an increase in spare time. Access to treatment for opioid use disorder (OUD) was interrupted by the measures meant to mitigate the spread of COVID-19. Through a systematic review of current literature, it was demonstrated that …

Evaluating The Effectiveness Of Restorative Justice Rehabilitative Services Available In Northeast Tennessee For Mothers Diagnosed With Substance Use Disorder, Claire Roberson

Undergraduate Honors Theses

Substance Use Disorder (SUD) has plagued families of rural Appalachia for many years, perpetuating involvement in the criminal justice system as well as generational trauma for people diagnosed with SUD and their children. This points to the necessity of a trauma-informed, restorative-justice based framework for rehabilitative services to most effectively heal families, address trauma, and re-integrate people diagnosed with SUD into society. A restorative justice-based program would provide health care services for addiction and any comorbid mental health disorders as well as teach parents how to properly provide for themselves and their families, manage finances, obtain employment, and further education. …

The Distribution Of Opioid Settlement Funds In Northeast Tennessee, Amani Patel

Undergraduate Honors Theses

Opioid Use Disorder is defined by the NIH as “the chronic use of opioids that causes

clinically significant distress or impairment.”1 Due to a number of factors, the overuse of opioids has become an epidemic in the United States. In recent years there have been a number of lawsuits against pharmaceutical companies and other parties who have benefitted from the proliferation of this issue. In most cases, it is up to the states or local governments who receive these funds to determine their best use. The purpose of this Thesis is to analyze the resources recommended by Ballad Health’s Community …

Nursing Students, Bullying, And Burnout: A Study On Bullying By Medical Staff Members Against Nursing Students In The Clinical Setting And Its Relation To Nursing Student Burnout, Kihley Bellamy

Undergraduate Honors Theses

The present study investigated the existence of bullying by medical staff members in the clinical setting as experienced by nursing students, the existence of burnout among these students, and if such students perceive feelings of burnout as directly related to experiences of bullying. Undergraduate main campus traditional Bachelor of Science in nursing students at East Tennessee State University in their second, third, fourth, or fifth semesters were invited to participate in the study. Participants (n=52) were required to complete an online survey that regarded bullying, burnout, and how participants perceive the relation between the two variables. The study shows that …

Covid-19 In Tennessee: Lessons Learned And A Tool For The Future, Allen Archer, Randy Wykoff, Megan Quinn

Undergraduate Honors Theses

Background: In late 2019, the SARS-CoV-2 virus was identified in Wuhan, China. Within a matter of weeks, the virus spread to the United States and many other countries around the world. By March 5, 2020, the first case of COVID-19 (the disease caused by the SARS-CoV-2 virus) was identified in the state of Tennessee, and the first known COVID-19 associated death in the state followed on March 20, 2020. In 2020 alone, there were 514,922 confirmed cases and 6,760 COVID-19 attributed deaths in the state of Tennessee. It is important to understand, however, that confirmed COVID-19 deaths do not accurately …

The Effects Of The Transition From Pre-Nursing To Nursing On Mental Health, Andrew J. Davis, Paige R. Mullins, Kimberly A. Sell

Undergraduate Honors Theses

Mental health is an ever-growing crisis among adolescents and young adults, with suicide as second leading cause of death and the number of those negatively affected continually on the rise. Transitions are one of the major stressors prevalent among these age groups, placing individuals at risk for mental health deficits. This quantitative voluntary response comparative study assesses the transitional mental health of pre-nursing students and students in the nursing program at East Tennessee State University. Emailed to all with a declared major of pre-nursing or nursing, this study measured mental health using evidenced based assessment tools. The PHQ-9 for depression …

The Fecal Fermentation Profile Of Infants With Different Feeding Modalities, Willow Lewis, Michelle E. Johnson, William A. Clark, Amy Wahlquist

Undergraduate Honors Theses

Introduction/Background

Research indicates nutrition and environment in the first year of a child's life are crucial in their development and growth and can contribute to lower chances of developing obesity and other health concerns. Key factors that can determine these outcomes include the bacteria and resulting short chain fatty acids (SCFAs) present in the gut. This composition may be affected by feeding modality (formula feeding vs breastfeeding), exposure to the mother’s microbiota, weight status of the child, and type of delivery. This research aims to identify the impact of infant feeding modality on toddlers' fecal fermentation profile, and if there …

Comparison Of Short Chain Volatile Fatty Acids In The Breastmilk Of Normal And Overweight/Obese Mothers, Ellen Gaskill, W Andrew Clark, Kristy L. Thomas, Amy Wahlquist, Michelle E. Johnson

Undergraduate Honors Theses

INTRODUCTION: Health professionals emphasize the importance of breastfeeding in the development of children up to 6-months of age. It is known that short chain volatile fatty acids (SCVFAs) are a byproduct of nutrient fermentation by gut microbiome. These SCVFAs interact with the gut/brain axis and are known to influence infant development. Therefore, a reflection of maternal gut microbiome could likely be found in breastmilk (BM) due to diffusion of SCVFAs across the gut wall into the blood. Previous research in our laboratory has shown differences in the SCVFA fecal fermentation profile between individuals with normal (N) versus overweight/obese (OWOB) body …

Investigation On Bacterial Signaling Through Generation Of A Ppgpp Biosensor, Andrew Robinson

Undergraduate Honors Theses

Guanosine tetraphosphate (ppGpp) is a bacterial signaling molecule involved in activating the stringent response, a cellular reaction to environmental stress that downregulates cell division and metabolism processes to conserve nutrients. The stringent response is implicated in some instances of antibiotic persistence, so broadening the current understanding of ppGpp signaling is useful. This thesis seeks to generate a ppGpp biosensor that will bind ppGpp and emit fluorescent light in its presence, which will allow for improved research into the pathways and functions of the signaling molecule. To generate a novel ppGpp biosensor, I converted a biosensor previously used to detect cyclic …

Neuroanatomical Distribution Of Neurons Within The Hypothalamic Paraventricular Nucleus That Project To The Brainstem Rostral Ventrolateral Medulla, Nicolas Fuller

Undergraduate Honors Theses

The sympathetic nervous system is important in maintaining cardiovascular homeostasis. Elevated cardiovascular-related sympathetic activity can lead to neurogenic hypertension and a host of other serious cardiac-related abnormalities. The paraventricular nucleus (PVN) of the hypothalamus plays an important role in sympathetic cardiovascular regulation. Neurons from the PVN project to the rostral ventrolateral medulla (RVLM), which is the main brain stem sympathetic cardiovascular control center. While RVLM-projecting PVN neurons have been well characterized, the topographical organization within the PVN subnuclei is still not fully known. This neuroanatomical study aimed to map the topographical distribution of RVLM-projecting PVN neurons. Four different carboxylate FluoSphereTM …

An Assessment Evaluating The Possible Participation Of A Virtual Nutrition Education Program For Older Adults, Ashlyn Cobble

Undergraduate Honors Theses

The importance of proper nutrition education among older adults is crucial in promoting overall physical health and management of chronic health conditions. However, access to such education has been limited, especially during the COVID-19 pandemic. With the current boom in social media popularity, as well as virtual communication portals such as Zoom, the question must be asked if nutrition education could be effectively implemented for the use of older adults through these electronic channels. The study design for this particular research was a cross sectional survey to inform development of an online nutrition education program for older adults in Northeast …

An Exploration Of Low-Income Dental Services In The Tri-Cities, Macie Proffitt

Undergraduate Honors Theses

Dental care has great importance in the overall health of every individual. Many do not realize the effect oral health plays in their overall health and many areas in the United States do not have access to the dental care needed to obtain proper healthcare standards. In many of these areas, such as the Appalachian region, dental services for low-income citizens are limited. Specifically, in the Northeast Tennessee region, these dental services are severely limited. Washington County and Hawkins County of Northeast Tennessee are specific underserved areas in the Appalachian region. The purpose of this project was to explore the …

Severe Hypoxia Up-Regulates Gluconeogenesis In Daphnia, Morad C. Malek

Undergraduate Honors Theses

Hypoxia is a significant low oxygen state that has complex and diverse impacts on organisms. In aerobes, various adaptive responses to hypoxia are observed that vary depending on the level of oxygen depletion and previous adaptation, hence the continued attention to hypoxia as an important abiotic stressor. Adaptive responses to hypoxia are primarily governed by the hypoxia-inducible factors (HIFs), which activate downstream genetic pathways responsible for oxygen transport and metabolic plasticity. In aquatic habitats, oxygen availability can vary greatly over time and space. Therefore, aquatic organisms’ adaptation to hypoxia is likely pervasive, especially in genotypes originating from waterbodies prone to …

Long-Term Effects Of Estrogen Deficiency On Cardiac Systolic Function And Hypertrophy Following Chronic Sympathetic Stimulation, Pamela Avendano

Undergraduate Honors Theses

Cardiovascular disease (CVD) is the leading cause of death worldwide. Pre-menopausal women have a lower incidence and severity of CVD compared to age-matched men. However, at the onset of menopause, CVD increases. A central feature in patients with CVD is excessive chronic sympathetic stimulation (CSS) of β-adrenergic receptors (β-AR’s). Clinical and animal studies show estrogen deficiency and age exacerbate cardiac β-AR signaling and contractile function. This led to the hypothesis that prolonged estrogen deficiency followed by CSS worsens left ventricular cardiac function and hypertrophy in the aged female heart. Female mice underwent bilateral ovariectomy or SHAM surgery at 2.5 months …

Genetic Characterization Of A Klebsiella Pneumoniae Secreted Anti-Microbial Protein, Ethan Becker

Undergraduate Honors Theses

Antimicrobial-resistant bacteria are a major source of ailment in modern-day nosocomial settings, with numerous risks including leading to possible further drug resistance or spreading to those who cannot fight off the infection due to immune suppression or dysfunction. Previous work in our laboratory has determined that Klebsiella pneumoniae possesses inhibitory effects on the growth of a variety of bacteria that contain antimicrobial-resistant properties in the Enterobacteriaceae family, a major source of nosocomial antimicrobial-resistance. This novel property of K. pneumoniae inhibits the growth of Citrobacter freundii, Enterobacter aerogenes, and Enterobacter cloacae through an anti-microbial protein. The antimicrobial protein secreted from K. …

The Impact Of Long Term Ovariectomy On Diastolic Function And Fibrosis Following Chronic Sympathetic Stimulation In Mice, Erin Moore

Undergraduate Honors Theses

Cardiovascular Disease (CVD) accounts for the leading number of deaths worldwide. Prior to menopause, women exhibit lower rates of CVD compared to age-matched men, however, risks for women increase with menopause. Studies show estrogen loss and age exacerbating cardiac β-adrenergic receptor (β-AR) signaling and contractile function. We therefore hypothesized that prolonged estrogen deficiency and chronic β-adrenergic stimulation cause decreases in cardiac function and increases in fibrosis in aged female hearts. Female mice underwent either an ovariectomy (OVX) or a control SHAM surgery at 10 weeks old and were infused with Isoproterenol for three days via mini osmotic pumps in …