Medicine and Health Sciences Commons^™

Strategies Used By Hospitals In A Southeastern State To Reduce Catheter Associated Urinary Tract Infections: Comparing The Outcomes By Hospital Structure And Processes, Furnell Rife

Electronic Theses and Dissertations

Catheter-Associated Urinary Tract Infections are considered a clinical indicator of quality of care. A descriptive research study was conducted to identify the strategies used by hospitals to reduce or eliminate CAUTIs. Infection Control Preventionists were surveyed. In a predominately rural southeastern state, this study demonstrated that about 40% of hospitals surveyed are implementing CAUTI prevention processes.

Evaluation Of Heat Stress In Migrant Farmworkers, Stephen L. Mcqueen

Electronic Theses and Dissertations

The rate of heat-related fatalities in crop production workers is almost 20 times that of other industries. Heat stress was investigated in migrant tomato workers in July, 2012, using measurements of body temperature, heart rates, body weight loss, evaluation of the thermal environment, and survey data. Using occupational safety criteria, these workers were found to work in an environment that should require protective measures to prevent heat strain. Increases in body temperature, heart rate, and physiological strain correlated with heat exposure. One third of workers had body weight percentage losses that indicated dehydration. However, working in hot environments appears to …

Expectations And Experiences Of Fathers Who Have Parented Children With And Without Intellectual Disabilities, Jane Christina Kusmik Walker

Electronic Theses and Dissertations

The parenting experience is as diverse as the children parented. Each child has diverse personality traits requiring flexibility and specificity in parenting strategy. This need for flexibility and specificity is more complex when one or more children within a family has an intellectual disability. Although research in this area is abundant, investigators have historically focused on mothers' attitudes, beliefs, and behaviors to represent the entire family (Essex, Seltzer, & Krauss, 2001; Greenberg, 2002) rather than focusing on fathers and their caregiving relationships with their children in need of malleable but consistent parenting. Using a qualitative descriptive design, this qualitative study …

Do The Opportunities Offered During The School Day Provide The Recommended Physical Activity Levels For Children?: An Assessment Of The Upson County Pre-Kindergarten And Elementary School Physical Activity Occurrences, Cheryl Lynn Robinson Gaddis

Electronic Theses and Dissertations

Problem Statement: Almost 90% of students do not meet the national recommendations for physical activity in school. The purpose of this study was to determine the need for school policy changes to incorporate classroom-based physical activity programs in an effort to increase school physical activity levels for children in grades pre-kindergarten through five by assessing the levels of and the barriers/facilitators to physical activity engagement.

Methods: This was a sequential explanatory mixed methods study utilizing school board members, principals, and teachers in the Upson County School System as participants. The online survey was adapted from the School Health …

Role Of Therapeutic Devices In Enhancing Speech Intelligibility And Vocal Intensity In An Individual With Parkinson’S Disease, Swetha Swaminathan

Electronic Theses and Dissertations

The prevailing speech therapy techniques for treating hypokinetic dysarthria in individuals with Parkinson's disease (PD) yields improvements within the clinical setting, however, maintenance and generalization of acquired behaviors continue to be a challenge. The purpose of this study was to investigate the effects of portable therapeutic devices including Ambulatory Phonation Monitor with biofeedback (APM) and auditory masker in maintenance and carryover of improved speech. Our participant was an individual diagnosed with PD for the past 25 years who continued to display speech disturbances despite undergoing several behavioral speech therapy programs and neurosurgical procedures. Speech intelligibility and average intensity measures under …

Il-1Β Amplification Of Nitric Oxide Production And Its Inhibitory Effects On Glucose Induced Early Growth Response-1 Expression In Ins-1 Cells, Ada Young

Electronic Theses and Dissertations

The pathophysiology of cytokines released by infiltrating white blood cells upon pancreatic beta cells is not fully understood. Early growth response gene-1 (Egr-1) expression is specifically and transiently up regulated in pancreatic beta cells in response to glucose. We hypothesized that interleukin-1 beta (IL-1▀) induction of nitric oxide alters glucose induced Egr-1 transcription levels. Egr-1 levels were assessed via western blot, nitric oxide was measured with a Griess Reagent kit and insulin levels via ELISA. Glucose induced both insulin and Egr-1 production in INS-1 cells. IL-1▀ dose dependently increased nitric oxide production over time and significantly attenuated glucose induced Egr-1 …

Rapid Detection Of Streptococcus Mutans In Saliva, Catherine E. Holtman

Electronic Theses and Dissertations

Documentation exists that mothers can pass the cariogenic bacteria Streptococcus mutans to their infants. The newest technology to identify Streptococcus mutans is a rapid detection saliva test. Two hundred patients above the age of 18 were targeted using random selection in a Louisville, Kentucky dental office. Patients signed an informed consent form and were given a qualifying questionnaire. Patients received 2 bitewing x-rays and a charted DMFT index and were administered the saliva test. While the null hypothesis was rejected using the chi square test, the results were inconclusive due to expected values. However, other chi square results revealed that …

Advancing Global Tobacco Control: Exploring Worldwide Youth Attitudes And Behaviors Toward Tobacco Use And Control, Sreenivas Phanikumar Veeranki

Electronic Theses and Dissertations

Tobacco use continues to be the leading cause of preventable death in the world. The disproportionate increase in tobacco use in low- and middle-income countries needs immediate attention. Many smokers begin smoking as adolescents and are most likely to become permanent smokers. Moreover, youth are highly targeted by tobacco industry strategies. However, a gap exists in literature to understand worldwide youth tobacco use and control. The purpose of this study is to 1) identify factors that influence never-smoking youths‟ smoking susceptibility, 2) explore characteristics that influence youth exposure to environmental tobacco smoke (ETS) and 3) to delineate key determinants of …

Cell-Matrix Adhesion In Muscle Development And Disease, Michelle F. Goody

Electronic Theses and Dissertations

A variety of diseases, both inherited and acquired, affect muscle tissues in humans. The anchoring of muscle fibers to their surrounding environment is critical for muscle homeostasis. Muscle fibers attach to their microenvironment through cell-matrix adhesion complexes. These anchoring complexes are placed under repeated stress during muscle contraction. Genetic mutations in these complexes weaken the attachment between muscle fibers and their microenvironment, making fibers more susceptible to damage and death. This increased fiber degeneration eventually leads to progressive muscle wasting diseases, known as congenital muscular dystrophies. Although clinical trials are ongoing, there is presently no way to cure the loss …

Protein Aggregation Through Acoustic Cavitation, John A. Giarratano

Electronic Theses and Dissertations

Therapeutic proteins represent an essential piece of a health management plan for diseases such as diabetes, cancer, hemophilia, Crohn's Disease, and myocardial infarction. These proteins, however, must be maintained in their correct, biologically active conformation throughout processing, transportation, and delivery. This requirement poses serious engineering challenges because of a protein's susceptibility to thermodynamic instabilities resulting from the weak bonds driving the tertiary structure of the molecule. A particularly problematic type of protein degradation is aggregation. Administration of aggregated proteins, a particularly problematic degradation form, can have dire consequences, including blocking a patient's responsiveness to therapy, inducing immunogenicity, and even anaphylactic …

Effects Of Burn Injury On Biological Ethanol And Ethyl Glucuronide Concentrations, Trista Haupt Wright

Electronic Theses and Dissertations

Alcohol is the most abused drug in the United States and most frequently performed assay in forensic laboratories. Alcohol is routinely present in biological specimens from fatal residential fires and forensic toxicologists must interpret if these individuals are impaired by determination of their blood alcohol concentrations on post-incineration blood collected at autopsy. There is no known data available to confirm or refute blood alcohol concentrations and impairment in fire-related deaths. Ethyl glucuronide (EtG), a non-volatile minor ethanol metabolite, may provide a better biomarker for ethanol consumption prior to burn injury. The literature does not address the possibility that ethanol or …

Exploring The Unique Characteristics Of Cancer In Adolescents And Young Adults In Tennessee, Megan Quinn

Electronic Theses and Dissertations

Adolescents and Young Adults (AYAs) ages 15-39 years with cancer have received little attention in the medical and health fields, resulting in a lack of progress for this age group. Little is known about the unique biologic, epidemiologic, and psychosocial issues that play an integral role in the AYA cancer journey. The purposes of this study were to use the Tennessee Cancer Registry for all new cancer cases from 2004-2008 to determine 1) the main types of cancer that affect AYAs in TN, 2) the predictors of late-stage diagnosis of melanoma, and 3) the factors that predict a total thyroidectomy …

A Measurement Of Readiness For Tennessee Hospitals To Implement “Meaningful Use” Criteria Resulting From The American Recovery And Reinvestment Act, 2009, Kathryn Wallin Wilhoit

Electronic Theses and Dissertations

In 2009, the American Recovery and Reinvestment Act was signed into law. This legislation provided for monetary rewards for those acute-care hospitals that meet "meaningful use" computerization and reporting criteria.

The study used a descriptive, nonexperimental design to answer three research questions (1) What is the level of readiness to meet "meaningful use" criteria in the Tennessee Hospital Association (THA) member hospitals; (2) What is the level of readiness to meet "meaningful use" criteria in the rural THA member hospitals; and (3) Is there a difference in the readiness to meet "meaningful use" criteria between rural and urban THA member …

The Effects Of Nicotine Administration On Behavior And Markers Of Brain Plasticity In A Rodent Model Of Psychosis, Marla K. Perna

Electronic Theses and Dissertations

Schizophrenia affects about 1% of the population. A hallmark of the disorder is increased dopamine D2 receptor sensitivity in the brain. Studies have shown that schizophrenics smoke cigarettes at approximately 4 times the rate of the general population. It has been suggested that nicotine use is a form of self-medication for symptoms in schizophrenia. Smoking behaviors typically begin in adolescence. We assessed effects of nicotine on behavior and brain plasticity in an adolescent rodent model of schizophrenia with the goal of identifying targets for smoking cessation. Methods: Rats were neonatally treated with quinpirole (a D2/D3 agonist) or saline and sensitized …

Healthcare Technology: A Strategic Approach To Medical Device Management, Chad A. Kinley

Electronic Theses and Dissertations

The constant evolution of medical technology has increased the demand for managing medical devices to ensure safety and effectiveness. In this paper I will investigate how biomedical engineering has addressed the issue of equipment management and identifies strategies to successfully maintain an inventory of medical devices. Through research, on-the-job experience, and in-depth discussions with various biomedical engineering managers, I have been able to document possible equipment strategies and best practices for managing medical devices. There is really no "one size fits all" to medical equipment management due to the various clinical environments, but there are many aspects that remain necessary …

A Consensus Model For Electroencephalogram Data Via The S-Transform, Andrew Coady Young

Electronic Theses and Dissertations

A consensus model combines statistical methods with signal processing to create a better picture of the family of related signals. In this thesis, we will consider 32 signals produced by a single electroencephalogram (EEG) recording session. The consensus model will be produced by using the S-Transform of the individual signals and then normalized to unit energy. A bootstrapping process is used to produce a consensus spectrum. This leads to the consensus model via the inverse S-Transform of the consensus spectrum. The method will be applied to both a control and experimental EEG to show how the results can be used …

Prelamin A Influences A Program Of Gene Expression In Regulation Of Cell Cycle Control, Christina N. Bridges

Electronic Theses and Dissertations

The A-type lamins are intermediate filament proteins that constitute a major part of the eukaryotic nuclear lamina—a tough, polymerized, mesh lining of the inner nuclear membrane, providing shape and structural integrity to the nucleus. Lamin A (LA) filaments also permeate the nucleoplasm, providing additional structural support, but also scaffolding numerous tethered molecules to stabilize, organize, and facilitate molecular interactions to accomplish critical functions of cellular metabolism. Over the past 2 decades, much attention has been focused on roles of LA in maintenance of nuclear structural integrity. Only since the late 1990s have scientists discovered the devastating effects of LA gene …

Approaches In The Treatment Of Parkinson's Disease : A Focus On Stem Cell-Based Therapies., Tareq Al-Maqtari 1979-

Electronic Theses and Dissertations

Parkinson's disease (PD) is a hypokinetic movement disorder resulting from the progressive neurodegeneration of the dopaminergic nigrostriatal system in the brain and the resulting imbalance between dopamine and acetylcholine in the basal ganglia motor circuitry. Although drug-based therapy approaches have shown dramatic symptomatic improvement in patients, they do not halt the progressive nature of the disease and their long-term use is associated with distressing adverse side effects. Consequently, several studies have aimed at discovering effective non-pharmacological strategies to reduce or to eliminate the need for drugs and possibly to halt or to reverse the neurodegenerative process in PD. Surgical deep …

Stabilization Of The Cardiac Nervous System During Cardiac Stress Induces Cardioprotection, David D. Gibbons

Electronic Theses and Dissertations

The cardiac nervous system consists of nested reflex feedback loops that interact to regulate regional heart function. Cardiac disease affects multiple components of the cardiac nervous system and the myocytes themselves. This study aims to determine: 1) how select components of the cardiac nervous system respond to acute cardiac stress, including myocardial ischemia (MI) and induced neural imbalance leading to cardiac electrical instability, and 2) how neuromodulation can affect neural-myocyte interactions to induce cardioprotection. Thoracic spinal cord stimulation (SCS) is recognized for its anti-anginal effects and ability to reduce apoptosis in response to acute MI, primarily via modulation of adrenergic …

Predictors Of Immunosuppressant Adherence In Long-Term Renal Transplant Recipients, Sandra J. Galura

Electronic Theses and Dissertations

To sustain the health and viability of renal transplants, adherence to immunosuppressant therapy (IST) medications is critical. Studies continue to identify decreased adherence rates as time from transplant increases (Chisholm-Burns, Kwong, Mulloy & Spivey, 2008; Chisholm, Lance, Mulloy, 2005; Chisholm, Mulloy, & DiPiro, 2005; Nivens & Thomas, 2009). While previous research has explored the effect of variables known to influence IST adherence in adult renal transplant recipients, limited studies have explored these variables in a population of renal transplant recipients with longer time posttransplant intervals. The purpose of this study was to examine demographic variables, time posttransplant, immunosuppressive agents, health …

Development Of The Tagalog Version Of The Western Aphasia Battery-Revised, Carmina Ozaeta

Electronic Theses and Dissertations

There has been limited research done in the Philippines in the area of aphasia, a frequent concomitant symptom of strokes and presents as impairment in any area of the input and output of language. Diagnosis is generally conducted by clinicians based on sites of lesion of speakers with aphasia and clinical observations of language symptoms and unpublished translation of the WAB. The lack of relevant research and formal assessment tools in the Philippines motivated this current study. The development of this type of assessment battery for the Tagalog (pronounced /təˈɡɑːlɒɡ/ in English) speaking population will provide a means for differential …

The Effects Of Phosphatidylserine On Reaction Time And Cognitive Function Following An Exercise Stress, Adam John Wells

Electronic Theses and Dissertations

Phosphatidylserine (PS) is an endogenously occurring phospholipid that has been shown to have cognition and mood enhancing properties in humans, possibly through its role as an enzyme co-factor in cellular signal transduction. Specifically, PS has been identified as activator of classical isoforms of protein kinase C, an enzyme known to be involved in the growth and differentiation of neural cells, and is therefore thought to play a role in the protection of neurons. The purpose of this study was to examine the effects of supplementation with PS and caffeine on measures of cognition, reaction time and mood prior to and …

Phosphatidic Acid Increases Lean Body Tissue And Strength In Resistance Trained Men, David Williams

Electronic Theses and Dissertations

Phosphatidic Acid (PA) is a natural phospholipid compound derived from lecithin which is commonly found in egg yolk, grains, fish, soybeans, peanuts and yeast. It has been suggested that PA is involved in several intracellular processes associated with muscle hypertrophy. Specifically, PA has been reported to activate protein synthesis through the mammalian target of rapamycin (mTOR) signaling pathway and thereby may enhance the anabolic effects of resistance training. To our knowledge, no one has examined the effect of PA supplementation in humans while undergoing a progressive resistance training program. To examine the effect of PA supplementation on lean soft tissue …

The Self-Described Experience Of Coping And Adaptation Associated With Workplace Stress Of Registered Nurses In The Acute Care Setting In Florida: An Ethnographic Study, Joyce Burr

Electronic Theses and Dissertations

Little is known about how nurses learn and use coping and adaptation skills in the workplace. Quantitative studies have identified the factors, nature, and outcomes of nursing stress. However, qualitative studies describing the human experience associated with workplace stress are lacking. The phenomenon of interest for this study using focused ethnographic method is the self-described experience of coping and adaptation associated with workplace stress of registered nurses working 12-hour shifts employed in acute care hospital facilities in east central and central Florida. Three aspects of the phenomena were examined: the self-described experiences of stress, the manner in which coping skills …

Impact Of Cancer-Specific Advance Care Planning On Anxiety, Decisional Conflict, And Surrogate Understanding Of Patient Treatment Preferences, Lynn Waser

Electronic Theses and Dissertations

Patients with life-limiting cancer and their families face unique challenges that interfere with their ability to make decisions or adequately express their health care preferences about end of life (EOL) treatment. As a result, patients at EOL often receive aggressive unwanted treatment that nationally costs billions of dollars and results in surrogate distress about not honoring patient wishes. Respecting Choices® DS-ACP is a disease-specific Advance Care Planning (ACP) intervention that is designed to overcome barriers associated with ACP and potentially decrease the incidence of unwanted, overly aggressive treatments at EOL. The intervention is delivered to patient-surrogate dyads by a trained …

Examining Gender In Pharmaceutical Rhetoric Through A Cultural Studies Lens: A Case Study On The Gardasil Vaccine, Jennifer Fickley-Baker

Electronic Theses and Dissertations

On June 8, 2006, Merck announced the debut of Gardasil, the world's first vaccine found successful in preventing human papillomavirus (HPV) infections, a sexually transmitted infection that is one of the main causes of certain cancers in men and women, including cervical, vulvar, penile and anal cancers. To promote the vaccine's release, Merck launched Gardasil's "One Less" advertising campaign that included television commercials, print ads and a consumerfocused website (www.Gardasil.com), each promoting the message that "you" could now be "one less woman" affected by cervical cancer ("One Less" campaign). The vaccine, tested and approved only for females age 9-26, was …

Front-Line Registered Nurse Job Satisfaction And Predictors: A Meta-Analysis From 1980 - 2009, Deborah Anne Saber

Electronic Theses and Dissertations

Front-line registered nurses (RNs) make up the workforce that directly affect the care of patients in a variety of different healthcare settings. RN job satisfaction is important because it is tied to retention, organizational commitment, workforce safety, patient safety, and cost savings. The strongest predictors have been difficult to determine because workplaces differ, numerous tools to measure satisfaction exist, the workforce is diversified by generations and work positions, and ongoing policy changes directly impact the work of the front-line RN. The strength and stability of the workforce depends on an accurate understanding of the predictors of job satisfaction for the …

Stressors Experienced By Emergency Department Registered Nurses At The Bedside: A Phenomenological Study, Stephen D. Heglund

Electronic Theses and Dissertations

The Emergency Department (ED) as a workplace for the Registered Nurse (RN) is a stressful environment. Reasons are thought to include interactions with other members of the interdisciplinary team as well as the situations associated with the environment of the ED such as trauma, death, sadness, joy and the general unpredictability of each moment. Studies have documented general health care workplace stress and its influence on staff, but a very limited number of studies have concentrated on the ED. No widely published studies have identified stressors from the perspective of the ED RN. This dissertation is an interpretive phenomenological study …

Influence Of Soil Microorganisms On Plant Growth And Fitness, Benjamin Jayne

Electronic Theses and Dissertations

Most terrestrial plants benefit from symbiosis with soil microorganisms. Symbiotic bacteria and fungi have wide-ranging effects on host plants, including improved nutrition, disease resistance, and drought tolerance. Association with Arbuscular Mycorrhizal Fungi (AMF) can enhance growth and protect plants from environmental stressors while they share products of photosynthesis with the resident fungi. Scores of studies indicate that mycorrhizal plants are more resistant to drought stress than their non-mycorrhizal counterparts. Use of microbes as a plant and soil supplement in home gardens represents a sustainable alternative to resource-intensive inputs and may allow for reduced water use. I investigated the effects of …

Development Of Novel Thermosensitive Polymers For Bioresponsive Drug Delivery, Vivek Kumar Garripelli

Electronic Theses and Dissertations

Stimuli-responsive polymers have already shotremendous promise in controlled and self-regulated drug delivery. Successful construction of responsive polymers requires amalgamation of chemical, physical and biological principles. For careful therapy, a great deal of advantages offered by stimuli-responsive polymers is essential. A small or modest change in the environmental condition (e.g. temperature, pH, light) brings a sharp change in the properties of the responsive polymers. 'Smart' drug delivery systems utilize these principles to mimic the biological response behavior to a certain extent. Synthetic polymers incorporated with stimuli-responsive behavior would be amenable to overcome some of the systemic and intracellular delivery barriers. Development …