Medicine and Health Sciences Commons^™

The Efficacy Of A Social Communication Intervention To Increase Syntactic Complexity In Narratives Of Children With Language Impairment, Alexandra Smith

Theses and Dissertations

Research has shown that children with Language Impairment (LI) struggle with social communication skills in addition to their characteristic syntactic difficulties. This pilot study analyzed the potential change in grammatical complexity in narratives of five children with LI when enrolled in a social communication intervention. The intervention itself focused on teaching emotion understanding by reading and reenacting children’s stories and journaling. Grammatical limitations were indirectly addressed by clinician modeling of complex forms during the intervention sessions. Each child’s productions were assessed and analyzed for grammatical complexity during retelling a book in the Mercer Mayer “a boy, a dog, and a …

Use Of The Robson Classification To Assess Caesarean Section Trends In 21 Countries: A Secondary Analysis Of Two Who Multicountry Surveys, Joshua P. Vogel, Ana Pilar Betrán, Nadia Vindevoghel, João Paulo Souza, Maria Regina Torloni, Jun Zhang, Özge Tunçalp, Rintaro Mori, Naho Morisaki, Eduardo Ortiz-Panozo, Bernardo Hernandez, Ricardo Pérez-Cuevas, Zahida Qureshi, A Metin Gülmezoglu, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Rates of caesarean section surgery are rising worldwide, but the determinants of this increase, especially in low-income and middle-income countries, are controversial. In this study, we aimed to analyse the contribution of specific obstetric populations to changes in caesarean section rates, by using the Robson classification in two WHO multicountry surveys of deliveries in health-care facilities. The Robson system classifies all deliveries into one of ten groups on the basis of five parameters: obstetric history, onset of labour, fetal lie, number of neonates, and gestational age.

Methods: We studied deliveries in 287 facilities in 21 countries that …

The Influence Of Race And Gender On Hiv Risk Behaviors In High School Students In The Southern States Of The United States, Malendie T. Gaines

Electronic Theses and Dissertations

The incidence of the Human Immunodeficiency Virus (HIV) is highest in the southern states of the United States (US), with adolescents in this region being one of the most affected populations in the country. A limited amount of information is available on adolescent HIV risk behaviors in the southern states, specifically focusing on race and gender. The purpose of this study was to use the Centers for Disease Control and Prevention’s National Youth Risk Behaviors Survey (YRBS) for high school students in the southern states for 2011 and 2013 to examine the influence of race and gender on 1) early …

Radiography Faculty Perceptions Of The Effectiveness Of Asynchronous Online Courses, Shirley J. Cherry

Electronic Theses and Dissertations

The purpose of this study was to assess radiography faculty perceptions of the effectiveness of asynchronous online courses. Learning effectiveness in a web-based virtual learning environment (VLE) was the conceptual framework for this project (Piccoli, Ahmad, & Ives, 2001). For the purposes of this study, learning effectiveness was defined as the quality of learning being comparable between online and traditional courses (Moore, 2011).

Ten research questions were used to guide this study, and statistical tests were conducted to evaluate 17 null hypotheses. The statistical tests included use of one-way analysis of variance (ANOVA), Pearson correlations, and single-sample t-tests. Ten of …

Role Of Ataxia Telangiectasia Mutated Kinase In The Healing Process Of The Heart Following Myocardial Infarction, Laura L. Daniel

Electronic Theses and Dissertations

Ataxia telangiectasia (AT), caused by mutations in the gene encoding ataxia telangiectasia mutated kinase (ATM), is a rare autosomal recessive disorder. AT individuals exhibit neuronal degeneration and are predisposed to cancer. Carriers of this disorder are predisposed to cancer and ischemic heart disease. Heart disease, mostly due to myocardial infarction (MI), is a leading cause of death in the US. Following MI, release of catecholamines in the heart stimulates β- adrenergic receptors (β-AR). Our lab has shown that β-AR stimulation increases ATM expression in the heart and myocytes, and ATM plays an important role in β-AR-stimulated myocardial remodeling with effects …

Productions Of Metalinguistic Awareness By Young Children With Sli And Typical Language, Lucy E. Long

Electronic Theses and Dissertations

This study seeks to: (1) determine if differences exist between children with Specific Language Impairment (SLI) compared to age-matched (AM) and language- matched (LM) children with typical language development (TL) in rates and proportions of five types of metalinguistic productions and (2) test theories of metalinguistic production. Forty-five children, 24 with TL and 21 with SLI, paired for age or language level, formed two groups. Previously collected data from two studies of verb learning (Proctor-Williams & Fey, 2007; Proctor- Williams, unpublished) were analyzed for rates and types of metalinguistic productions. Results yielded no within or between group significant differences in …

A Hierarchical Graph For Nucleotide Binding Domain 2, Samuel Kakraba

Electronic Theses and Dissertations

One of the most prevalent inherited diseases is cystic fibrosis. This disease is caused by a mutation in a membrane protein, the cystic fibrosis transmembrane conductance regulator (CFTR). CFTR is known to function as a chloride channel that regulates the viscosity of mucus that lines the ducts of a number of organs. Generally, most of the prevalent mutations of CFTR are located in one of two nucleotide binding domains, namely, the nucleotide binding domain 1 (NBD1). However, some mutations in nucleotide binding domain 2 (NBD2) can equally cause cystic fibrosis. In this work, a hierarchical graph is built for NBD2. …

Training Clinical Judgment Skills For Interpreting Feeding Behavior In Preterm Infants: A Comparison Of Video And In Vivo Simulation, Jamesa R. Ewing

Electronic Theses and Dissertations

Health and feeding outcomes for preterm infants depend upon healthcare providers’ ability to recognize non-verbal signs of distress during bottle-feeding. Methods of training future providers’ to interpret feeding behavior in preterm infants are unclear. This study used a pre-test/post-test design to compare the effects of in- vivo simulation and video-simulation training on students’ knowledge of feeding abnormalities, clinical judgment, and documentation accuracy. Fifty-two graduate level speech-language pathology students were assigned to the in-vivo (N= 27) or video-simulation (N= 25) group. Results revealed that both methods proved beneficial for increasing knowledge and clinical judgment skills. Participants trained using video-simulation training documented …

Exploring The Relationship Between Early Childhood Attentional Control And Language Ability, Jaima S. Price

Electronic Theses and Dissertations

Relatively few studies have investigated the relationship between early childhood attentional control and later cognitive outcomes, especially language development. The current study is an investigation of the relationship between the executive functioning (EF) component of attentional control and language ability in the second year of life. More specifically, the predictive nature of two aspects of attentional control, attentional focus and resistance to distraction, was be the primary focus of the proposed study. Although it was expected that children both high in attentional focus and resistance to distraction would have significantly superior language development than infants with lower attentional capacities, analyses …

Inverse Changes In Ghrelin And A2a Receptor Gene Expression Levels In The Hippocampus Of Heart Failure Canines Following Spinal Cord Stimulation, Benjamin E. Jewett

Undergraduate Honors Theses

Myocardial infarction (MI), often referred to as a heart attack, is a serious health issue in the United States. There is a well-documented link between MI and major depressive disorder (MDD), with a high incidence of MDD occurring after an MI. Overlapping pathologies have been observed within the hippocampus of the brain in animal models of MI and depression. These observations suggest that pathobiological cross-talk between the heart and brain could have a role in the etiology of MDD that occurs after an MI. Spinal cord stimulation (SCS) has previously been shown to have both cardioprotective and neuroprotective effects post-MI, …

The Perception Of Latino Mothers’ Experience With The Healthcare System In East Tennessee, Christopher G. Bush

Undergraduate Honors Theses

As the Hispanic population continues to grow in the United States, especially in the South, it is critical for healthcare workers to provide culturally competent care as required by certain laws. The Latina experience is of significant importance due to the role Latina mothers play in their families and communities. It is necessary to understand the perspective of this population and the experience of the Latina mother in regards to healthcare; specifically, how have language barriers hindered care, what perceptions of bias or discrimination have been encountered, and how do these factors influence their healthcare decisions and outcomes. Research has …

Anti-Neoplastic Effects Of Extracts From Gnaphalium Gracile On Colon, Pancreatic, And Prostate Cancer Cells, Joshua R. Canter

Undergraduate Honors Theses

Over 4,000 flavonoids have been identified, and among these, many of them are known to possess cardioprotective, anti-inflammatory, antimicrobial, and antitumor effects. However, most of these properties have yet to be fully understood. In this study, extracts from Gnaphalium gracile, thought to possess a mixture of flavonoids, have been tested for cytotoxic activity on pancreatic (MiaPaca, Panc28), colon (HCT-116, Caco-2), and prostate (PC3, LNCaP), cancer cell lines. Polar extracts from the leaves of G. gracile have the most cytotoxic effect on these cancer cell lines, particularly the prostate cancer cell lines PC3 and LNCaP. Evidence suggests the extracts have …

Formulation And Optimization Of Aliskiren Loaded Poly(Lactide-Co-Glycolide) Nanoparticles, Jessica M. Coleman Ms.

Undergraduate Honors Theses

Aliskiren is a non-peptide, orally active renin inhibitor with poor absorption and low bioavailability (~2.6%). In order to improve the current drug delivery system, a commercially available, biodegradable copolymer, poly(lactide-co-glycolide) (PLGA), was employed for a nanoparticle (NP) reformulation of aliskiren. An emulsion-diffusion-evaporation technique was implemented where aliskiren and PLGA were dissolved in dichloromethane, ethyl acetate, or ethyl acetate/acetone. To an aqueous phase containing 0.25% w/v didodecyldimethylammonium bromide (DMAB) as stabilizer, the previously prepared organic phase was added drop-wise. Following sonication, NP diffusion was expedited with the addition of water, and the organic phase was evaporated to form a …

Tobacco Use And Attachment Style, Mary Heath Wise

Undergraduate Honors Theses

Tobacco has been recognized as the number one cause of preventable death in America and results in almost 5.2 million years of potential life lost each year. The use of tobacco products is highly correlated with pulmonary disease, cardiovascular disease, and other forms of chronic illness in America. Within the last ten years new tobacco products have been trending in the tobacco market such as the water pipe/hookah and e-cigarettes. With e-cigarettes and other newer forms of tobacco on the rise, it is important to look at the underlying factors for using all kinds of tobacco products as a means …

Assessing The Nutrition Knowledge And Body Image Perceptions Of Minority Freshman At East Tennessee State University, Michele L. Becerra

Undergraduate Honors Theses

The health status of African American and Hispanic communities is in need of intervention. These minority groups have a health disparity gap from other races. The incidences of hypertension, diabetes, and obesity are greater in the African American and Hispanic communities. There is a need to continue addressing the specific health issues, along with ideas of body perception, plaguing the African American and Hispanic populations in the United States. Such disparities typically include those who follow “western” diets, have a lack of exercise, are predisposed to chronic illness, as well as have a need for continuous education of the subject …

A Retrospective Chart Review To Profile Appalachian Fall Risk, Hannah M. Warren

Undergraduate Honors Theses

This study was designed to create a high-risk fall profile for a specific Appalachian community. Data were obtained from 1,598 individuals with fall-related injuries who had been had been evaluated at a Level 1 Trauma center in Northeast Tennessee throughout 2011 and 2012, ages of individuals were 18 to 85 years. Data collected included: age, gender, county of fall, site of fall, type of fall, number of co-morbidities, season of fall, and time of day of fall. Results showed differences in criteria for categorizing individuals at high risk of falls, as well as data that had not appeared in the …

Potential Role Of Rta3 And Gnp3 Transport Genes In The Quorum Sensing Response Of Candida Albicans, John G. Magnuson

Undergraduate Honors Theses

Quorum sensing (QS) is a mechanism of communication between cells to coordinate biological activities. In the opportunistic fungal pathogen Candida albicans, QS is important for regulating the organism’s ability to change morphology from a yeast form to a hyphal form. Previously, our laboratory identified several genes involved in polymicrobial communication between C. albicans and three bacterial species. We hypothesize that interspecies communication and QS utilize the same genetic pathways to control C. albicans morphological behavior. In this study, two transport genes, RTA3 and GNP3, and their involvement in QS were examined. To test whether these two genes participate in QS, …

Nurse’S Perceptions Of Visitor’S Adherence To Transmission-Based Precautions, Jocelyn K. Spenillo

Undergraduate Honors Theses

Transmissions based precautions are measures implemented in various clinical health care settings as a means to prevent the transmission of infectious diseases and decrease instances of healthcare acquired infections (HAI). HAI’s result in increased cost to hospitals, longer hospitalization for patients, increased patient suffering, and fatal patient outcomes. While staff member adherence to transmissions based precautions are mandated through various organizations and hospital policies, a review of literature indicates little research has been conducted regarding visitor compliance with transmission-based precautions. The potential implications in healthcare from visitor non-adherence acquired infections are unknown; revealing a gap in literature and supporting the …

Psychosocial Determinants Of Physical Activity In Children Attending Afterschool Programs : A Path Analysis., Jiying Ling, Lorraine B. Robbins, Valerie L. Mccarthy, Barbara J. Speck

Faculty and Staff Scholarship

Background: Physical activity (PA) is important for controlling childhood obesity, but a comprehensive PA model for school-aged children is lacking.

Objectives: Guided by the youth PA promotion (YPAP) model, this study estimated the direct and indirect effects of self-efficacy, enjoyment, parental influence, and environment on self-reported PA and pedometer steps. A secondary purpose was to explore the association between self-reported PA and pedometer steps.

Methods: An observational and prospective study was conducted among 133 children, aged 8–11 years old, from 10 elementary schools with afterschool programs in a Midwestern U.S. school district from August through October 2013. …

Evaluating The Effectiveness Of Cranial Molding For Treatment Of Positional Plagiocephaly Using Finite Element Analysis, Maziyar Keshtgar

Master's Theses

Since the advent of recommendations for placing infants in the supine position during sleep to reduce the incidence of sudden infant death syndrome, clinicians have noted an increase in the frequency of cranial asymmetry due to deformation of suture sections of the infants’ skulls as a result of constant concentrated stress in one area at the back of their head. This specific form of cranial deformation is known as positional plagiocephaly and its rate of occurrence has increased from 0.3% in 8.2% within the past 30 years.

Current treatments and methodologies for preventing and correcting positional plagiocephaly such as stretching …

Nurses Caring For Adults With Autism In An Emergency Department: A Survey Of Knowledge, Shauna Marie Miller

Doctoral Projects

Autism is a complex neurodevelopmental disorder characterized by social impairments, communication difficulties, and restricted, repetitive, and stereotyped patterns of behavior. The nurse (RN) in the emergency department (ED) plays an important role in the receiving, treatment, and management of the patient with autism. RNs must understand the unique challenges of caring for individuals with autism. Fortunately, autism is an active area of research, with copious resources available to assist those affected by this disorder; however, no studies were found evaluating nurses’ knowledge of autism and the number of resources for nurses caring for this population was limited. Nursing is an …

Pediatric Nurse Practitioner Home Visitation Is Associated With A Decrease In Home Care And Healthcare Utilization Errors In High Risk Infants, Rupalee Patel

Doctoral Projects

The Santa Clara Valley Health and Hospital System’s (SCVHHS) Babies Reaching Improved Development and Growth in their Environment (BRIDGE) program was developed in 2011 to optimize high risk infants' care transition from Neonatal Intensive Care Unit (NICU) to home. In addition to hospital discharge teaching and public health nursing efforts, NICU infants need further in home support given their medical vulnerability after discharge. The objectives of the SCVHHS BRIDGE program are to provide caregiver interventions to minimize home care errors after NICU discharge and to optimize health care access and utilization across the transition of care. SCVHHS NICU infants at …

Heath Care Providers’ Perceptions Of The Reproductive Challenges And Experiences Among Asian Indian Women Living In Silicon Valley, Olga Alexandra Libova

Doctoral Projects

Objective: To identify common reproductive challenges among Asian Indian (AI) women living in Silicon Valley as perceived by healthcare providers (HCP). Design: A 71-item investigator-developed survey Setting: The survey was available on-line to all HCPs in California Santa Clara county, 75% of respondents were affiliated with El Camino Hospital Mountain View. Participants: Convenience sample of 78 respondents: 34% mother-baby nurses, 24% labor-delivery nurses, 21% OB/GYNs, 7% CNMs, 14% other HCP; 89% female; 55% Caucasian, 24% Asian. Methods: Likert-type scales comparing prevalence of certain reproductive challenges among AI women and women from other race-ethnic groups and openended questions regarding HCPs’ experience …

Outcome Analysis And Quality Improvement For Inter-Hospital Transfers Of Pediatric, Carma Lynn Tobiassen

Doctoral Projects

Pediatric patients who initially present to a community hospital setting can be adequately cared for the majority of the time, in the emergency department (ED), on the pediatric ward (PEDS), and the post anesthesia care unit (PACU). When a pediatric patient is in need of specialized care or is decompensating and becomes critically ill, initial medical stabilization is required and the identification of a critical care bed and admitting physician are needed in a timely manner. Inter-hospital transfers (IHT) of pediatric patients are frequent occurrences, as more and more areas are consolidating their resources and Pediatric Intensive Care beds are …

Developing A Patient Care Standard For Adolescents Based On A Nursing Needs Assessment, Kathryn Blake

Doctoral Projects

Mental health patients often suffer from chronic medical conditions and psychiatric comorbidities requiring frequent emergency, primary care, and acute care visits (Douzenis et al., 2012). Caring for psychiatric patients in acute care hospitals has become an increasing burden on healthcare systems with processes in place to care for acute and critical care patients. Healthcare leaders, providers, emergency departments, and medical/surgical hospitals are straining to provide care for complex patients with acute medical conditions and complex mental health needs (Reiss-Brennan, Briot, Savitz, Cannon, & Staheli, 2010). Caring for children and adolescents with medical and psychiatric problems creates the need for a …

Exploring College Students' Perceptions Of College Gun Violence: A Meta-Analysis, Julia Chaw Chih Lee

Doctoral Projects

College gun violence has been one of our nation’s most forefront issues in recent years. The present meta-analysis reviewed studies reporting college students’ perceptions about school/college gun violence in order to summarize the total effect and direction of these research findings. There were only two studies identified for this research topic: Study A and Study B. Combining the effect sizes from both studies could not be accomplished because there was not enough data from Study A to calculate the correlation coefficient(r) or standardized mean difference (SMD). The summary of the results of the two studies as a metaanalysis was more …

Bio-Identical Hormones Utilized For Treating Menopausal Symptoms: Are They Safe?, Maria D. White

Doctoral Projects

The use of compounded bioidentical hormones in the various forms of gels, creams, and troches has increased in popularity. The population of menopausal women is at a crossroads with the cascade of symptoms and determining what are their options. The Endocrine Society, the Food and Drug Administration, and the National Menopause Society do not support the use of bioidentical hormones, despite the support for bioidentical hormone replacement therapy (BHRT) by the American Academy for Anti-Aging Medicine and other proponents for BHRT. The literature review reveals the need for studies documenting the safety of BHRT. The objective for this study was …

Pain Management At End Of Life When There Is A Co-Occurrence Of Substance Use Disorder: A Qualitative Metasynthesis, Kristina Olfson

Doctoral Projects

Pain management, end of life (EOL) care, and substance use disorder (SUD) are individually identified as National healthcare challenges and priorities. Despite 50 years of advances in the understanding of pain management, pain is still inconsistently assessed and undertreated in all populations, including those with life limiting illness. When a patient with a life limiting illness and history of SUD is encountered, pain management becomes further complicated. Effective pain management for all patients, regardless of coexisting complications, is an ethical obligation of health care providers. Given the lack of research into EOL pain management of patients with SUD, it is …

A Comparison Of Pedagogical Approaches To Error Communication Training, Marie Annette Gilbert

Doctoral Projects

Purpose: The purpose of this study was to compare the effectiveness of two different pedagogical approaches to error communication training.

Background: The literature advocates full, transparent communication following a medical error. However, many barriers to such disclosure exist. A significant barrier is healthcare providers do not feel prepared for these difficult conversations. This can be particularly challenging in a pediatric setting when the conversation with a parent may be more demanding than similar conversations in the non-pediatric settings.

Method: Individuals from three different professional groups were recruited; physicians, pharmacists, and nurses. A randomized controlled study was conducted to investigate …

A Special Report Of Current State Of The Medical Physicist Workforce - Results Of The 2012 Astro Comprehensive Workforce Study, Erli Chen, Anna Arnone, Jussi K. Sillanpää, Yan Yu, Michael D. Mills

Department of Radiation Oncology Faculty Papers

No abstract provided.