Medicine and Health Sciences Commons^™

The Regulation Of Dna Methylation In Mammalian Development And Cancer, Nicolas Veland

Dissertations and Theses (Open Access)

DNA methylation is an essential epigenetic modification in mammals, as it plays important regulatory roles in multiple biological processes, such as gene transcription, maintenance of chromosomal structure and genomic stability, genomic imprinting, retrotransposon silencing, and X-chromosome inactivation. Dysregulation of DNA methylation is associated with various human diseases. For example, cancer cells usually show global hypomethylation and regional hypermenthylation, which have been implicated in genomic instability and tumor suppressor silencing, respectively. Although great progress has been made in elucidating the biological functions of DNA methylation over the last several decades, how DNA methylation patterns and levels are regulated and dysregulated is …

Development Of 3d-Printed Patient Specific Bolus For Clinical Use In To Tal Scalp Irradiation, Garrett Baltz

Dissertations and Theses (Open Access)

Total scalp irradiation (TSI) is a specialized radiation therapy technique that aims to deliver a uniform dose to the entire scalp. Original electron-based TSI techniques had limited homogeneity due to hot and cold spots created at field junctions due to the multiple matched fields that were required to treat the entire scalp. The transition to photon volumetric-modulated arc therapy based TSI techniques has improved homogeneity, to the point where non-conformal bolus is now a limiting factor. Bolus is required to build-up full dose to the scalp surface in total scalp irradiation. Creating bolus that is conformal to the scalp is …

A Survey Of The Implementation And Usage Of Electronic Dental Records And Digital Radiographs In Private Dental Practices In Mississippi, Barbara K. Brent

Electronic Theses and Dissertations

Implementation of electronic health records by the Health Information Technology for Economic and Clinical Health has led to the implementation of electronic dental records (EDRs) and digital radiography in dental offices. The purpose of this study was to determine the state of the implementation and usage of EDRs and digital radiographs by the private general and pediatric dental practices in Mississippi as well as reasons why the dental practices are not moving forward with the advanced technology.

A survey was emailed to 712 dental practices: 116 responded (16% response rate), and 104 consented to participate (89.66%). Results indicated dental practices …

Hiv-Related Knowledge, Attitudes, And Behaviors In Two Low Resource Settings, Candice Lynn Collins

Electronic Theses and Dissertations

Two Human Immunodeficiency Virus (HIV) outbreaks occurred almost simultaneously in the United States (US) (2014-2015) and in Cambodia (2015). Information is lacking on HIV-related knowledge, stigmatizing attitudes, and high-risk behaviors (KAB) among the general population, which may affect the transmission of HIV and lead to outbreaks. The current study aimed to: 1) assess KAB among the general population in a high-risk county in the US, 2) analyze KAB among the general population of Cambodia, and 3) compare KAB across samples from a high-risk county in Northeast Tennessee and a province in Cambodia. Tennessee data were collected in 2017 and Cambodian …

Success Rates Of Second Semester Anatomy Students In Online And On-Ground Classes At A Community College In East Tennessee, William Sproat

Electronic Theses and Dissertations

Educators expect the number of institutions offering online courses and the number of students enrolling in these courses to increase as many students, particularly nontraditional students, discover the advantages of online content delivery. Online courses require new methods of communication between students and faculty as well as discovering new ways to build relationships, earn student trust, conduct appropriate assessment, and deliver useful course content. Many institutions—public, private, and for-profit—offer a wide variety of online coursework but faculty, employers, and the public have expressed concerns about the quality of online course content. In particular, online delivery of coursework in the natural …

Exploration Of Rape Myths Among Former Military Professionals, Gabrielle Caldara

Electronic Theses and Dissertations

Sexual violence is sometimes considered a taboo topic for discussion, but it gained widespread attention in the media in late 2017 due to the social movements addressing the sexual assault of women. However, sexual violence perpetrated against men lacks publicity in America, and highlights a similar situation in the Armed Forces. A discussion of sexually violent acts committed against men is sometimes impeded by cultural norms. This discrepancy associated with civilian and military communities inspired this exploratory study.

A convenience sample of 520 former American military professionals completed an anonymous online survey to describe their attitudes and beliefs regarding rape …

Context, Delivery, And Providers’ Perspectives Of Family Life Education In Tn, Usa, Ruby Yadav

Electronic Theses and Dissertations

In 2015, TN had the 9^th highest teen birth rate in the United States. School-based sex education programs have shown promise in curbing teen pregnancy rates. In TN public schools, sex education could be taught by teachers of subjects like biology, health education, or invited guests from ministries, or national or local nonprofit agencies. The content, rigor, and approach of sex education taught by these diverse groups of providers remains unknown. This pilot study tested a survey questionnaire and methodology, while providing information on the providers’ sex education practices and perspectives.

We adapted validated measures from past sex education …

Health Professions Faculty Beliefs, Confidence, Use, And Perceptions Of Organizational Culture And Readiness For Ebp: A Cross-Sectional, Descriptive Survey, Kerry A. Milner, Holly B. Bradley, Tammy M. Lampley

Nursing Faculty Publications

Background: Evidence-based practice (EBP) is an essential skill and ethical obligation for all practicing health professions clinicians because of its strong association with improved health outcomes. Emerging evidence suggests that faculty who prepare these clinicians lack proficiency to teach EBP.

Book Review: Surrogacy: A Human Rights Violation By Renate Klein, Sheela Saravanan

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

An Exploratory Study Of Military Management Practices, Physical Activity, And The Prevalence Of Shin Splints In Rotc Cadets, Jakayla Campbell

Electronic Theses and Dissertations

Medial Tibial Stress Syndrome (MTSS, Shin splints) is very common in military personnel accounting for up to 35% of incidences, which is almost twice the incidence seen in the average active individual. Each year there is in increase number of injuries in Army recruits. Though Army Reserve Officer Training Corps (ROTC) programs are known for commissioning approximately 60% of 2^nd Lieutenants and 40% of generals on active Army duty, no research has been done examining MTSS occurrences in relation to military management practices. Therefore, the purpose of this study is to explore the relationship between military management practices and …

Assessing Readiness For Group Therapy In Primary Care: An Initial Survey Exploring Need, Philip Randall

Electronic Theses and Dissertations

Primary care providers have become the front line of treatment for mental health in the United States. Group interventions have been argued to be an effective way to treat more patients with fewer resources, which could reduce the burden of psychopathology on primary care settings. Group therapy faces many barriers to successful implementation in primary care, including site constraints, provider perceptions, population needs, and recruiting difficulties. A survey was developed to assess primary care providers’ perspectives on these areas and distributed via online survey to practitioners in Appalachia; 28 providers responded. No hypotheses were supported, likely a result of the …

The Effects Of Dance Therapy On Voice In Patients With Parkinson's Disease In A Multicultural Population, Ivon N. Ramirez

Theses and Dissertations

Current literature suggests that dance therapy in individuals with Parkinson’s disease shows noticeable improvement in motor functions, for example gait and balance improvement. Additionally, patients with Parkinson’s disease who participate in dance therapy may perceive positive benefits on their quality of life. Therefore, it is believed that increases in core support and improvements in posture, as a result of dance therapy, will have effects on the voice in patients with PD.

This thesis pulls from literature supporting treatment approaches in the field of speech-language pathology for voice patients with Parkinson’s disease. The aim of this study was to evaluate the …

Implementation Of A Sustainable Medicare Annual Wellness Visit Workflow Into A Primary Care Setting Quality Improvement Project., Alejandro Hernandez Md, Lynn M. Wilson Do, Kevin Mcneill Md, Susan S. Mathieu Md, Susan Sell Bsn, Rn

Department of Family Medicine

No abstract provided.

A Role Of Vitamin B2 In Reducing Amyloid-Beta Toxicity In A Caenorhabditis Elegans Alzheimer’S Disease Model, Muhammad Tukur Ameen

Electronic Theses and Dissertations

Alzheimer’s disease (AD) is associated with amyloid-beta peptide deposition and loss of mitochondrial function. Using a transgenic C. elegans AD worm model expressing amyloid-beta in body wall muscle, we determined that supplementation with either of the forms of vitamin B₂, flavin mononucleotide (FMN) or flavin adenine dinucleotide (FAD) protected against amyloid-beta mediated paralysis. FMN and FAD were then assayed to determine effects on ATP, oxygen consumption, and reactive oxygen species (ROS) with these compounds not significantly improving any of these mitochondrial bioenergetic functions. Knockdown of the daf-16/FOXO transcriptional regulator or the FAD synthase enzyme completely abrogated the …

The Combined Neuropharmacology And Toxicology Of Major 'Bath Salts' Constituents Mdpv, Mephedrone, And Methylone, Serena Allen

Electronic Theses and Dissertations

The synthetic cathinones, 3,4- methylenedioxypyrovalerone (MDPV), 4-methylmethcathinone (mephedrone), and 3,4- methylenedioxymethcathinone (methylone), gained worldwide notoriety as the psychoactive components of ‘bath salts;’ a marketing term used to circumvent federal drug laws and permit their legal sale. Previous studies have shown that these drugs share pharmacological characteristics with cocaine and the amphetamines, however, descriptions of their neurotoxic properties are limited. Moreover, while forensic analysis has revealed that the most frequently abused bath salts ‘brands’ contain binary and ternary mixtures of MDPV, mephedrone, and methylone, the majority of preclinical research has focused on explicating the individual effects of these drugs. Therefore, the …

The Inhibitory Effects Of A Novel Gel On Staphylococcus Aureus Biofilms, Lindsey Vance

Undergraduate Honors Theses

Antibiotic resistance is an ever-growing topic of concern within the medical field causing researchers to examine the mechanisms of resistance to develop new antimicrobials. Bacteria’s ability to form biofilms is one mechanism which aids in antimicrobial resistance. Staphylococcus aureus is of special interest as it is one of the most frequent biofilm-forming bacteria found on medical devices causing infections and posing dangerous threats in a clinical setting. A recently developed antimicrobial gel has been shown to have profound effects on treating bacterial infections and wound healing. This research is centered upon examining the antimicrobial effects of this gel on the …

Interdisciplinary Knowledge Of Etsu Dental Hygiene And Nutrition Students, Jade Merritt

Undergraduate Honors Theses

There is a significant relationship between nutrition, systemic disease, and oral health. The integration of both nutrition and oral health information into educational programs for dental hygiene and nutrition students is vital for each profession. The purpose of this study was to determine the knowledge levels of dental hygiene and nutrition students in regards to content material pertaining to each discipline. This study attempted to provide baseline data for those teaching in ETSU’s Dental Hygiene and Nutrition programs to determine if modifications in the curricula are needed to better prepare future students. Results indicated that there was not a significant …

A High-Level Overview Of How The New Accounting Standard Update On Revenue Recognition Impacts The United States Healthcare System, Leslie Johnson

Undergraduate Honors Theses

In May of 2014 the Financial Accounting Standards Board (FASB) and the International Accounting Standards Board (IASB) issued a long-awaited joint updated standard on revenue recognition, ASU 2014-09 – Revenue from Contracts with Customers. While almost all entities will be affected to some extent by the new standard, particularly the changes in required disclosures, this research seeks to examine the impact the new standard will specifically have on the healthcare industry. By highlighting areas of significant challenge a better understanding will be gained of the impact health care service entities will experience as they transition to a new standard.

Sex Differences In Mechanisms Of Recovery After Isometric And Dynamic Fatiguing Tasks, Jonathon Senefeld, Hugo M. Pereira, Nicholas Elliott, Tejin Yoon, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Purpose The purpose of this study was to determine whether supraspinal mechanisms contribute to the sex difference in fatigability during and recovery from a dynamic and isometric fatiguing task with the knee extensors.

Methods: Transcranial magnetic stimulation and electrical stimulation were used to determine voluntary activation and contractile properties of the knee extensors in 14 men and 17 women (20.8 ± 1.9 yr) after a 1) 60-s sustained, maximal voluntary isometric contraction (MVIC), and 2) dynamic fatiguing task involving 120 maximal voluntary concentric contractions with a 20% MVIC load.

Results: There were no differences between men and women in the …

Pituitary Adenylate Cyclase-Activating Polypeptide (Pacap) Signaling In The Prefrontal Cortex Modulates Cued Fear Learning, But Not Spatial Working Memory, In Female Rats, Adam J. Kirry, Matthew R. Herbst, Sarah E. Poirier, Michelle M. Maskeri, Amy C. Rothwell, Robert C. Twining, Marieke R. Gilmartin

Biomedical Sciences Faculty Research and Publications

A genetic polymorphism within the gene encoding the pituitary adenylate cyclase- activating polypeptide (PACAP) receptor type I (PAC1R) has recently been associated with hyper-reactivity to threat-related cues in women, but not men, with post-traumatic stress disorder (PTSD). PACAP is a highly conserved peptide, whose role in mediating adaptive physiological stress responses is well established. Far less is understood about the contribution of PACAP signaling in emotional learning and memory, particularly the encoding of fear to discrete cues. Moreover, a neurobiological substrate that may account for the observed link between PAC1R and PTSD in women, but not men, has yet to …

Dancing While Pregnant: Benefits And How To Do It Safely, Teagen Boyle

Undergraduate Honors Theses

Dancing While Pregnant by Teagen Boyle is about a very important question any female athlete may find themselves asking. How can I continue my sport while pregnant? Pregnancy is very strenuous and takes a toll on the human body; however, it is very important to stay healthy and continue exercising. Dance is a safe, no-contact sport that is really on the terms of the dancer. Therefore, dance is most likely a fun, safe form of exercise for pregnant women. Diving into research and looking up articles one may find little to no research. That is because there is barely any …

Longitudinal Measures Of Deformation Are Associated With A Composite Measure Of Contractility Derived From Pressure-Volume Loop Analysis In Children., Shahryar M. Chowdhury, Ryan J. Butts, Carolyn L. Taylor, Varsha M. Bandisode, Karen S. Chessa, Anthony M. Hlavacek, Arni Nutting, Girish S. Shirali, G Hamilton Baker

Manuscripts, Articles, Book Chapters and Other Papers

Aims: The relationship between echocardiographic measures of left ventricular (LV) systolic function and reference-standard measures have not been assessed in children. The objective of this study was to assess the validity of echocardiographic indices of LV systolic function via direct comparison to a novel composite measure of contractility derived from pressure-volume loop (PVL) analysis.

Methods and results: Children with normal loading conditions undergoing routine left heart catheterization were prospectively enrolled. PVLs were obtained via conductance catheters. A composite invasive composite contractility index (ICCI) was developed using data reduction strategies to combine four measures of contractility derived from PVL analysis. Echocardiograms …

A Newly Diagnosed Right Ventricular Outflow Tract Obstruction In The Setting Of Acute Bleed Post Cesarean., Kourtney Erickson Do, Lisa Lindauer Md

Department of Medicine

No abstract provided.

Psychiatric And Cognitive Adverse Events: A Pooled Analysis Of Three Phase Iii Trials Of Adjunctive Eslicarbazepine Acetate For Partial-Onset Seizures., Eva Andermann, Victor Biton, Selim R Benbadis, Bassel Shneker, Aashit K Shah, Mar Carreño, Eugen Trinka, Elinor Ben-Menachem, Arnaud Biraben, Francisco Rocha, Helena Gama, Hailong Cheng, David Blum, Study 301, 302 And 304 Investigators

Pharmacy Articles

OBJECTIVE: To evaluate the nature and incidence of psychiatric and cognitive adverse events (AEs) reported with eslicarbazepine acetate (ESL) used as adjunctive treatment for refractory partial-onset seizures (POS) in adults.

METHODS: This was a post-hoc analysis of data pooled from three randomized double-blind, placebo-controlled trials (BIA-2093-301, -302, -304). After an 8-week baseline period, patients received placebo or adjunctive ESL 400mg (studies 301 and 302 only), 800mg, or 1200mg once daily (QD) for 14weeks (2-week titration period, 12-week maintenance period). Psychiatric and cognitive AEs were identified from individual patient data. Suicidality was also evaluated using the Columbia-Classification Algorithm of Suicide Assessment …

Patient Perceptions Of Google Glass In The Outpatient Dermatology Setting, Sandra Odenheimer

Doctoral Projects

Background: The ubiquitous use of electronic health record (EHRs) during medical office visits using a computer monitor and keyboard can be distracting and disrupt patient-healthcare provider (HCP) non-verbal eye contact cues, which are integral to effective communication. Provider use of a remote medical scribe with face-mounted eyeglass technology, such as Google Glass (GG), may preserve patient-HCP communication in the healthcare setting by allowing providers to access other parts of the patient’s EHR (e.g. laboratory results, current medications, immunization records) all while maintaining direct eye contact with their patients. The medical scribe is able to chart patient encounters in real-time working …

Retrospective Analysis Of Obstetric Sepsis Screening, Holly A. Champagne

Doctoral Projects

This project was designed to evaluate outcomes following implementation of routine screening for sepsis in the obstetric population. A retrospective analysis of the electronic medical record of 204 women who met sepsis criteria using obstetric-adjusted systemic inflammatory response syndrome (SIRS) criteria and a source of infection was the method used. Outcomes were evaluated for neonates born to the women who developed sepsis during labor. The incidence of sepsis was 0.401 per1,000 and included those with antepartum, intrapartum, or postpartum admissions. The setting was a tertiary center with 5,075 deliveries over the study period. There were 92 (45.2%) who had sepsis, …

Perceptions Of Caring In The Pediatric Medically Complex Population, Ivette Becerra-Ortiz

Doctoral Projects

In a hospital system that transitioned from a non-caring science model to a professional practice model based on the Theory of Human Caring/Caring Science, it is important to measure the outcomes of the care delivery transition. In a non-experimental, cross-sectional, correlational, quantitative study the aim was to compare a pre/post-Caring Science model implementation at a pediatric and obstetric medical center, by assessing perceptions of caring in the medically complex pediatric population and in the nurses that care for them.

This study used a convenience sample of 102 pediatric families enrolled in a complex care program, and 23 nurses providing care …

Evidence-Based Study Of Medication Compliance Project In Hiv Prevention Using Pre-Exposure Prophylaxis (Prep) Antivirals For Hiv-Negative Males, Ming-Chun Ho

Doctoral Projects

In 2012, emtricitabine/tenofovir was the only Food and Drug Administration-approved medication for pre-exposure prophylaxis (PrEP) used in human immunodeficiency virus (HIV) prevention. To date, there is little research on open-label and mixed-payer characteristics supporting medication compliance of men who have sex with men (MSM). The purpose of this research was to describe individual demographic variables associated with PrEP medication adherence and to examine the effect of a follow-up phone call from a nurse once a month for 3 months. A total of 30 MSM were recruited and data were collected using a demographic questionnaire, medication adherence tool and follow-up phone …

Sexually Transmitted Infection Risk Reduction For College Students, Mary Kathryn Dowling

Doctoral Projects

University students have been assessed through many sexual health lenses, but there is a paucity of research on the sexual health of community college students. This population may provide good access to at-risk youth, and opportunity to reverse steep climbs in sexually transmitted infection (STI) rates. This research project pilot tests a theory-based intervention employing social facilitation to reduce STI risk among college students. Fifty students were recruited from Human Sexuality courses to participate in a 60-minute workshop. Pre- and post-testing measured for change in STI knowledge, attitude towards safer sex, and self-efficacy for engaging in safer sex practices.

A …

The Effectiveness Of Insulin Pump Therapy After Transition From Multiple Daily Insulin Injections In Type 1 Diabetes, Sima Sapkota

Doctoral Projects

The population of patients who have been diagnosed with diabetes mellitus (Type 1 or Type 2) has been increasing in the United States. Patients with type 1 diabetes may receive insulin through delivery via insulin pump therapy (IPT) or multiple daily insulin injections (MDII). In addition to requiring insulin, other management regimens have included frequent blood glucose monitoring, checking laboratory values hemoglobin A1c (A1C), maintaining normal body mass index (BMI), keeping a balanced diet, carbohydrate counting, and exercise. The purpose of the study was to compare the retrospective data of A1C and BMI of patients with type 1 diabetes after …