Education For Healthcare Professionals On Protocol For Prostate Cancer Screenings On Inmates, Heather Ackerman, Randi Janae Ballard

Doctor of Nursing Practice Projects

Cancer is the leading cause of death for incarcerated individuals, prostate cancer awareness and screening guidelines are essential areas of focus for healthcare professionals (Puglisi et al., 2021). Prostate cancer screenings recommend that males between the age of 55-69 be informed of evidence-based guidelines and offered these screenings as a part of routine health maintenance (USPSTF, 2018). In 2019, the Illinois Department of Corrections (IDOC) was ordered to follow these guidelines for incarcerated individuals (Raba, 2021). As of 2021, the IDOC had yet to implement these screenings for incarcerated individuals within the state facilities. Two separate one-hour educational sessions regarding …

Implementation Of Prenatal And Postpartum Depression Screening For A Telehealth Company, Allison Herrmann, Lori Deibel

Doctor of Nursing Practice Projects

Abstract

Depression is a leading mental health disorder. Depression occurring during the perinatal and postpartum periods has become highly prevalent throughout the world, impacting 5-10% of women during (van de Loo et al., 2018) and 9-23.5% postpartum (Bauman et al., 2020). Proper diagnosis and treatment of perinatal and postpartum depression (PPD) is crucial, as depression can lead to poor outcomes including relationship complications and negatively affect child development (Slomain, 2019). The implementation of screening tools can help identify women at risk based on their signs and symptoms of PPD (Bauman et al., 2020). The primary goal of this project was …

Pneumococcal And Influenza Vaccine Co-Administration In The Incarcerated Population, Kaitlyn Stroh

Doctor of Nursing Practice Projects

Background/Significance: Streptococcus pneumoniae is responsible for 20-60% of U.S. bacterial pneumonia cases and has a mortality rate of 10-30%. Invasive pneumococcal disease (IPD) occurs when streptococcus pneumoniae invades otherwise sterile sites. Adherence to immunization guidelines is 60-70% effective at preventing IPD. Co-administration of pneumococcal and influenza vaccines has shown promise at increasing uptake of the pneumococcal vaccine and enhancing immunological response. Population/Setting: A state-run Department of Corrections (DOC) clinic system serving just over 30,000 individuals was the site for this project. Incarcerated individuals present an increased risk of contracting pneumococcal disease due to close living quarters. Other risk factors such …

Implementation Of Menstrual Cycle And Fertility Awareness Education For Community Healthcare Providers Serving Guatemalan Women, Alissa Struble

Doctor of Nursing Practice Projects

Research indicates that lack of reproductive knowledge, literacy & academic attrition, lack of educator support, poverty, religion, gender inequality, and decreased access to electronic devices contribute to high numbers of teenage pregnancies in Guatemala. Educating United States (U.S.) healthcare providers and Guatemalan volunteers/workers about fertility awareness using Standard Days Method® (SDM) and CycleBeads® has the potential to empower young Guatemalan women and encourage them to make independent, informed reproductive decisions. In December 2023, a quality improvement project was implemented in a Guatemalan rural health clinic. Likert scale questionnaires were utilized to assess knowledge and comfort levels regarding fertility awareness. Analysis …

Psychiatric Mental Health Nurse Practitioner Perceptions Of How Providing Patient Care During The Covid-19 Pandemic Affected Their Own Mental Health, Linda Cabage

Electronic Theses and Dissertations

Public health concerns were prominent during the COVID-19 pandemic, particularly regarding rising cases of anxiety and depression among adults. U.S. healthcare providers were especially affected by the unrelenting demands on their time and service. Psychiatric Mental Health Nurse Practitioners (PMHNPs) provided patient care during the pandemic to meet the increasing need for mental health services as people began experiencing mood disturbances such as anxiety, depression, and grief. The purpose of this qualitative study was to explore the perceived effect of the COVID-19 pandemic on the mental health of PMHNPs. A qualitative design using the interpretive description method allows researchers to …

Bayesian Estimation Of Reproduction Numbers From Distributions Of Outbreaks Sizes: Branching Process Approach, Alberta Araba Johnson

Theses and Dissertations

The Generalized Poisson distribution is useful in modeling epidemiological processes as a branching stochastic processes problem. Our goal is to construct accurate and reliable estimators for the reproduction number (R0) (i.e., the number of secondary infections), particularly in the context of disease outbreaks modeled by a Galton-Watson process. Towards this goal, we construct the classical Bayes estimator, the Maximum Likelihood estimator, and the Empirical Bayes (EB) estimator under the Square Error Loss function in Chapter II. We prove that the Empirical Bayes estimator is asymptotically optimal and estimate the rate of convergence. We then proceed to monotonize the Empirical Bayes …

Telehealth Acceptance And Medical Mistrust Among The Elderly Of Rural Appalachia: A Correlational Study Using The Medical Mistrust Index And Technology Acceptance Model, Victoria Hood-Wells

Electronic Theses and Dissertations

Adults aged 65 years and above have grown substantially over with past decade. However, the chance of developing multiple comorbidities only increases with age. Because elderly residents of rural Appalachia often encounter barriers to healthcare, rural nurses, providers, and policy makers must overcome physical and structural barriers, but also gain a more in-depth understanding of the personal and cultural attitudes impacting the use of new and innovative forms of healthcare delivery. With a slow and variable uptake of telehealth adoption in rural Appalachia, and in the presence of well-documented medical mistrust, this study was designed to better understand the degree …

The Lived Experience Of Nurses In Caring For Patients With Covid-19, Jessica Barre

Electronic Theses and Dissertations

Limited research exists about the experiences of nurses’ caring for patients during the COVID-19 pandemic post hoc. To understand nurses’ realities of caring for patients with COVID-19, I aimed to understand the lived experience of nurses caring for patients with COVID-19 in the United States. A qualitative design with a hermeneutic phenomenological methodology was used. Sixteen participants were recruited via purposive sampling, augmented with snowball sampling. Data were collected through unstructured interviews and were analyzed using Braun and Clarke’s Reflexive Thematic Analysis. Nurses’ experiences of caring for patients with COVID-19 in the U.S. were consolidated into four themes: “a living …

Influence Of Medication Assisted Treatment Weaning On Neonatal Abstinence Syndrome And Outcomes Among Infants Born To Women With Opioid Use Disorder, Rakesh Adelli

Electronic Theses and Dissertations

Neonatal abstinence syndrome (NAS) is a drug withdrawal syndrome exhibited by infants born to mothers with opioid use disorder (OUD). The American College of Obstetricians and Gynecologists and other professional societies endorse opioid agonist pharmacotherapy (MATs) as the optimal treatment for OUD during pregnancy. This study focuses on impact of weaning of MAT drugs on the incidence of NAS and neonatal birth outcomes among babies born to women with opioid exposure.

The study population included eighty-six pregnant women with OUD, divided in to weaning and non-weaning groups based on their choice to wean the MATs during pregnancy. Univariate analysis was …

Pathology And Osteological Observations Of Early Pliocene Rhinoceros, Teleoceras Aepysoma (Perissodactyla, Rhinocerotidae) From Gray Fossil Site, Tennessee, Thomas Scaife

Electronic Theses and Dissertations

Rhinoceroses were an important part of North America’s Paleogene and Neogene ecosystems, with Teleoceras aepysoma being one of the last representatives of this family. Specimens of T. aepysoma from the Gray Fossil Site (GFS) possess distinct/peculiar pathologies: including a pair of fused ribs and ankylosed phalanges. A qualitative description of the pathologies in the GFS T. aepysoma, including new material, was conducted to accurately identify pathologies and make interpretations about the life history of the GFS rhinos. Analysis suggests that rheumatoid arthritis is common in the lower limb bones of GFS rhinos. Additionally, the rib and toe pathologies are more …

Perinatal Buprenorphine Effects On Offspring Growth, Opioid Withdrawal, And Brain Morphology In Rats, Parker Barnes

Electronic Theses and Dissertations

Opioid use disorder (OUD) impacts 5.6 million people in the US. Buprenorphine (BUP) is a commonly prescribed opioid medication used to treat OUD, including in pregnant women. However, opioid use during pregnancy is associated with poorer infant outcomes including reduced fetal growth, neurodevelopmental deficits, and neonatal opioid withdrawal syndrome (NOWS). Recent clinical data suggests that providing mothers with a lower dose of BUP may result in fewer negative outcomes in infants. Here, a preclinical rodent model of low-dose perinatal BUP exposure was used to study offspring health outcomes in the neonate, juvenile, and adolescent offspring. Dams were given clinically relevant …

Exploring The Lived Experience Of Self-Care In Young Adults With Type 2 Diabetes, Holly Berry-Price

Electronic Theses and Dissertations

Introduction

The prevalence of prediabetes in adults aged 18 or older was as high as 38% between 2017-2020. Youth-onset T2DM is a more aggressive phenotype than T2DM that occurs later in life. Young adults with T2DM have poorer health outcomes, lose an average of 15 years of life, all resulting in significant economic burden impacting the person. Current self-management interventions do not improve health outcomes in young adults with T2DM.

Purpose

The purpose of this research was to explore the self-care experiences of young adults living with T2DM.

Methods

Existential hermeneutic phenomenology informed the research. Inclusion criteria as follows: adults …

Targeting Coenzyme A Biosynthesis For Antifungal Development., Jessica Regan

Theses and Dissertations (ETD)

An estimated 1.5 million people die each year from invasive fungal infections (IFIs) involving dissemination to the deeper organs via the bloodstream, with estimated healthcare costs of over $7 billion in the U.S. alone. Collectively, several Candida species account for more than 75% of disseminated fungal infections in the U.S., with attributable mortality rates ranging 35-75%. Unfortunately, the prospect of curing these infections is limited by the modest efficacy of the available antifungal drugs: the azoles, echinocandins, and amphotericin B. Approximately one-third of patients with disseminated Candida infections are non-responsive to treatment with the azoles, and favorable response rates are …

Identifying Contributors To Acute Stroke Transfer Delays From Lower To Higher Level Stroke Centers, Jennifer Patterson

Theses and Dissertations (ETD)

The intricate process of efficiently transferring patients within the healthcare setting has proven to be complex however, it is a critical component to ensure timely access to essential medical interventions. Navigating these complexities presents a multifaceted challenge that is not fully understood. For patients suffering a stroke, these transfer delays may render them ineligible for treatment and left with disabling disability. This collective work aims to identify contributors to delays in transfer from lower to higher levels of care in the acute stroke populations.

Three papers emerged from this thesis. First, a narrative review of the literature published between January …

Social Workers’ Preparedness For Practice With Patients Experiencing Psychotic Disorders, Paula Crespin

Electronic Theses, Projects, and Dissertations

The present study explored the preparedness of social workers when providing services to individuals diagnosed with psychotic disorders who present with non-affective psychosis. The present study sought to examine the perceived barriers to mental health service utilization for individuals diagnosed with psychotic disorders as well as the perceived preparedness of social workers when providing services to individuals with non-affective psychosis. Social workers are crucial frontline workers in the treatment and support of individuals diagnosed with psychotic disorder. This qualitative study was comprised of twelve semi-structured interviews to gauge the preparedness of social workers (N=12). Results from the thematic analysis demonstrated …

Mexican Cookbook For People On Dialysis Treatment, Abigail Guadalupe Ellenich

Electronic Theses, Projects, and Dissertations

Dialysis is a treatment for patients with Chronic Kidney Disease (CKD) with nonfunctioning kidneys. Managing nutrition during dialysis is crucial for improving patients’ quality of life and involves moderate consumption of protein, potassium, phosphorus, calcium, sodium, and fluids. The objective of this project was to develop a cookbook that used traditional recipes from Mexican culture and modify the ingredients to meet the unique dietary needs of persons receiving dialysis. A qualitative assessment was performed to ensure that traditional flavors were retained. The recipes were obtained from various internet sources and ingredients were modified to meet and ensure compliance with the …

Factors That Contribute To Disparities In Access To Mental Health Services Within Hispanic Adults, Jasmine Soriano

Electronic Theses, Projects, and Dissertations

The focus of this research project was to understand and identify the challenges Hispanic adults face when accessing their mental health services to better understand this concerning issue and help support social workers in bridging that gap in the Hispanic community. The study took place at a mental health clinic in Southern California through virtual interviews for those who chose to participate. This agency provides mental health therapy to individuals 0-21 years of age, but for the purpose of this study, only adults aged 18-21 qualified to participate. The study consisted of twelve voluntary participants from both Hispanic adult clients …

Hispanic Cookbook For Individuals With Diabetes, Jewel Santamaria

Electronic Theses, Projects, and Dissertations

ABSTRACT

Introduction: Can a cookbook positively influence the quality of life for Hispanics with diabetes? The purpose of this study was to develop a cookbook that is diabetic-friendly and culturally appropriate using common traditional Hispanic ingredients and methods.

Methods: Recipes for traditional Hispanic dishes were modified to meet nutritional needs for people with diabetes. The modified recipes were very similar to traditional Mexican cuisine, except healthier ingredients and techniques were substituted from the original recipes. Nutritional analysis was conducted using Cronometer software, with inclusions of calories, protein, carbohydrates, and fat in the cookbook. Additionally, a carbohydrate exchange for each recipe …

Analysis Of The Right Sizing Approach To Healthcare Space Planning, Johnathan Anspach

All Theses

Achieving optimal spatial design in healthcare facilities is crucial for efficient operations and high-quality patient care. This study investigates the application of the right-sizing approach to healthcare conceptual design, with a specific focus on the Medical-Surgical Unit (MSU) and Intensive Care Unit (ICU) departments within inpatient wards. Utilizing a robust methodology, foundational parameters and constraints were established to align with the functional requirements of a 100-bed hospital case study. Through a systematic process, industry practitioners contributed valuable insights via surveys, facilitating the quantification of parameter rankings essential for spatial decision-making.

Analysis of the data revealed significant correlations between parameters, emphasizing …

Hand Movement Analysis For Surgical Suturing Skill Assessment, Amir Mehdi Shayan

All Theses

To enhance patient safety, surgical education is increasingly incorporating simulation for formative skills assessment and training. However, many standardized assessment tools rely on human raters for performance assessment, which is resource-intensive and subjective. Simulators that provide automated and objective metrics from sensor data can address this limitation. This thesis presents an instrumented bench suturing simulator, patterned after the Clock Face (CF) radial suturing model from the Fundamentals of Vascular Surgery (FVS), for automated and objective assessment of open suturing skills by particularly focusing on biomechanical analysis of hand movements. For this research, 97 participants (35 attending surgeons and fellows, 32 …

Photobiomodulation Of Bovine Oocytes During Maturation Increases Atp Content And Enhances Subsequent Embryonic Development, Kendall Richey

All Theses

Bovine in-vitro production(IVP) of embryos is a growing field for producing offspring with desirable genetics in the cattle industries. While IVP is effective, oocyte cytoplasmic maturation is compromised, and bovine oocytes matured in-vitro have reduced metabolic activity than those matured in-vivo. Mitochondria are the central unit of oocyte metabolism, producing ATP through OXPHOS. Photobiomodulation is a light treatment reported to improve metabolic activity. In five experiments, we measured the effects of photobiomodulation treatment with red LED at 16-(L-16) and 20 h(L-20) of bovine oocyte in-vitro maturation on subsequent embryonic development, mitochondrial activity and nuclear progression. Bovine COCs were aspirated …

Effect Of Source Of Trace Minerals On Nutrient Digestibility And Rumen Fermentation Of Dairy Cows, Cesar Velasquez Rios

All Theses

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An Assessment Of The Current State Of Nursing Homes In The United States, Southern Region, And Tennessee, Nicole Galler

Electronic Theses and Dissertations

Introduction: Nursing homes throughout the U.S. have faced unprecedented challenges in recent years because of staffing shortages, and under-investment, especially since the COVID-19 pandemic. To gain insight into the current state of nursing homes, this study examined nursing home characteristics, quality, and accessibility from a national, regional and state perspective.

Methods: This cross-sectional study used secondary data from the Centers for Medicare and Medicaid Services, American Community Survey, Medicare Beneficiary, and the Tennessee Department of Health. Nursing home characteristics and quality were assessed through bivariate and multivariate regression in the U.S. Assessment of HHS Region 4 nursing home characteristics and …

The Role Of The Speech-Language Pathologist With Survivors Of Traumatic Brain Injury From Intimate Partner Violence And Providers’ Knowledge Of This Role, Nicolle Mcadams

Electronic Theses and Dissertations

Intimate partner violence occurs globally at alarming rates. Many experience adverse health impacts such as traumatic brain injury. Healthcare providers do not know the role of the speech-language pathologist, or the rehabilitation needs of survivors.

Aims: This scoping review aims to identify speech-language pathology services for survivors of intimate partner violence with a resulting traumatic brain injury, and knowledge of healthcare providers on the rehabilitation needs of this population. A search was completed in May to October 2023, resulting in a total of 13 articles reviewed.

Main contributions: Speech-language pathologists lack knowledge to provide services to intimate partner violence survivors …

The Greater Implications Of Self-Perceptions Of Aging Among Younger Adults: Results From The Socially Nutritious Volunteer Training Program, Ashlyn Cobble

Electronic Theses and Dissertations

The rapidly growing rate of the older adult population has created a need to better understand younger adults’ self-perceptions of aging and current trends of ageism. The purpose of this secondary data analysis research project was to determine changes, if any, in participants’ self-perception of aging after the Socially Nutritious facilitator or nutrition ambassador volunteer training, which aims to develop knowledge and skills related to aging trends, older adult nutrition, preventing ageism, and communication and educational considerations when working with older adults. Findings indicate that participants with more frequent interactions with older adults had a more positive perception of their …

Validation Of A Novel Heritable Rodent Model Of Drug Abuse Vulnerability In Psychosis And Investigation Of Therapeutic Targets, Loren D. Peeters

Electronic Theses and Dissertations

Schizophrenia is a severe neuropsychiatric disorder of largely unknown etiology that is often accompanied by high rates of cigarette smoking, reduced quit success, and high relapse rates. Dysregulated dopamine signaling and aberrant synaptic plasticity in the mesocorticolimbic pathway are implicated in the pathophysiology of schizophrenia and conferred substance abuse disorder and relapse vulnerability. Genetic factors are presumed to play a significant role in the development of schizophrenia, with a 40-50% concordance rate for monozygotic twins, although genetic markers are inconsistent. As such, epigenetic factors have instead been implicated. Specifically, there is strong evidence to suggest DNA methylation at several candidate …

Healthcare Providers’ Screening And Counseling For Tobacco Use Among Youth In The United States: Prevalence, Practices, And Providers’ Perspectives, Adeola Omolade Ayo

Electronic Theses and Dissertations

Youth tobacco use is a public health concern in the United States (U.S.) with about 2.8 million middle and high school youth reporting current tobacco use in 2023. Healthcare providers (HCPs) can play a crucial role in addressing youth tobacco use through screening and counseling, yet rates of these interventions are suboptimal. Tennessee has a high prevalence of youth tobacco use and not much is known about these interventions in Northeast Tennessee. This study has several objectives: 1) conduct a scoping review of available evidence on screening and counseling for youth tobacco use and identify related gaps; 2) assess youth …

Exploring The Correlates And Predictors Of Covid-19 Vaccine Hesitancy And Uptake Among People Living With Hiv/Aids In Tennessee, Charles Olomofe

Electronic Theses and Dissertations

Background

The administration of the COVID-19 vaccines has met with resistance and hesitance from different population groups including people living with HIV/AIDS (PLWHA). It is concerning to know that PLWHAs are showing a higher rate of COVID-19 vaccine hesitancy than the general population. The objective of this study is to synthesize the literature and determine the correlates and predictors of COVID-19 vaccine hesitancy among PLWHA using primary and secondary data.

Methods

A scoping review was conducted to identify and summarize studies on COVID-19 vaccine hesitancy among PLWHA using the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) Extension for …

Familial Sex Trafficking In East Tennessee, Mary K. Brannock

Electronic Theses and Dissertations

This dissertation was completed in partial fulfillment of the Doctor of Public Health program at East Tennessee State University. The dissertation follows the Manuscript Format which includes three manuscripts, these manuscripts regard familial sex trafficking and are as follows, a scoping review, an empirical study on regional familial sex trafficking, and a policy implications paper on criminal record relief for survivors of familial sex trafficking.

The scoping review includes eight peer reviewed studies on familial sex trafficking and a summary of grey literature. Thematic analysis was used to map the existing literature onto the Three Ps of human trafficking: Prevention, …

The Association Between Prenatal Care And Postpartum Depression: Current State And Future Directions, Esther Adebayo-Abikoye

Electronic Theses and Dissertations

Background

Postpartum depression (PPD) is a major public health challenge and associated with poor maternal and infant health outcomes. Quality prenatal care decreases adverse outcomes in pregnancy and may reduce PPD risk factors. This study critically reviews the evidence about the role of prenatal care practices in reducing PPD prevalence across population groups and examines the association between prenatal care timing and counseling content with PPD prevalence.

Methods

A scoping review was completed across eight databases to synthesize evidence about prenatal care and PPD across different contextual settings. National data from the Pregnancy Risk Assessment Monitoring System (PRAMS) was used …