This thesis is a comparative study of variables affecting differentiation and proliferation of progenitor cells from various embryonic and fetal tissue sites as they differentiate into mast cells. Embryonic stem cells from gestation day 4.5 (d4.5) differentiated exclusively into mast cells when cultured in semi-solid media with stem cell factor (SCF) and Interleukin-3 (IL-3). The same was true of d8-1 1 yolk sac cells and d8-1 1 cells from the embryo itself. However, culture with SCF and IL-3 of cells from dl4 fetal livers differentiated into mast cells, cells of the erythrocyte lineage and a few "macrophages" which may have been similar to the stromal cell found in the bone marrow that supplies iron to and removes the nucleus from erythrocytes. An rythrocyte-nurturing role for the fetal liver "macrophages" was substantiated by removing cells expressing Mac1, and sorting for cells expressing the early mast cell marker, Kit, resulting in cells that differentiated only into mast cells with SCF and IL-3. The variables affecting proliferation that were studied were brief incubation at very high cell density, and co-culture with fibroblasts. In addition, a few experiments were done to determine the mechanism of the effect of these variables on proliferation. High cell density incubation increased proliferation of yolk sac, fetal liver and bone marrow cells. The increased proliferation of yolk sac and bone marrow cells was attenuated by an inhibitor of the sodium-ionlhydrogen-ion exchanger, 5-(N,N-hexamethylene) amiloride (HMA). The exchanger was also found to play a role in the subsequent proliferation of mast cells from bone marrow cells co-cultured with fibroblasts since, if HMA was present during the first thirty minutes of contact, mast cell proliferation decreased by 75%. Using fluorescent imaging, activation of this exchanger was monitored by an increase in intracellular pH. Altogether these results demonstrate a growing concept in developmental biology regarding the normal stem cell in its niche (tissue site) and the effects of exogenous variables on it. They substantiate the concept that the differentiation path and proliferation of a stem cell depends both on its past history and on its future circumstances.

Many academic medical programs present students with the chance to experience scenario based learning. This is often achieved through the use of clinical simulation laboratories which utilize computer-based scenarios that realistically imitate the human body and how it responds to various situations. This interactive style of learning has proven to be successful at integrating theories taught in textbooks and practice gained through clinical experience without posing any harm to human patients. Literature has shown documentation of the effectiveness of using clinical simulation laboratories in both the academic and clinical setting; however, some clinical facilities have been slow to adapt the use of this technology. The purpose of this study was to determine what factors are deterring the use of clinical simulation labs for the purpose of continuing education in the hospital setting. The study was limited to the field of respiratory therapy. The study was conducted by sending surveys to respiratory therapists and administrators working in acute care facilities in the Northeast region of Tennessee and the Southwest region of Virginia. The surveys included various questions concerning knowledge and perceptions of clinical simulation labs. The surveys were coded using a modified Likert scale, and the data was input into SPSS Version 18.0. Sample t-tests were then run where appropriate. Therapists indicated a preference for learning through the use of clinical simulation labs as opposed to learning through textbooks alone. Administrators indicated a knowledge of the benefits of clinical simulation labs even though the majority are not currently using the technology in their facilities.

Despite the vast amount of research regarding type II diabetes, little is known about the relationship between fatalistic beliefs and self-efficacy in individual self-care among adult Appalachians with type II diabetes. As a result of multiple predisposing risk factors that include high rates of obesity and poverty, as well as a lack of access to preventative care services, the prevalence of diabetes is very high in this region and has become a major health issue. In addition, a history of exploitation and lack of diverse economic development has profoundly influenced the cultural beliefs of those living within the region, which has resulted in Appalachians being collectively described as fatalistic. The purpose of this study was to determine if a correlation between fatalistic beliefs and self-efficacy in self-care among adult Appalachians with type II diabetes exists. A survey was created that assessed three concept areas pertaining to both fatalism and self-efficacy in self-care: emotional distress, religious/spiritual coping, and perceived self-efficacy. The survey was administered to participants being treated for type II diabetes at a rural clinic in northeast Tennessee. Expected correlations were found when comparing both emotional distress and perceived self-efficacy with religious and spiritual coping. However, an unexpected positive correlation was found when comparing emotional distress with perceived self-efficacy. In conclusion, this study did not demonstrate the hypothesized negative correlation between fatalism and self-efficacy, and the results found are not attributable to a larger population due to the small sample size obtained.

Due to the increase in the aging population older adults are looking for ways to stay fit and active in their later years. Such activities need to be fun, easy to operate, and encourage socialization. The Nintendo Wii© Bowling provides these features for the aging population. Participants in this quantitative pilot study had the opportunity to play the Nintendo Wii© Bowling Game twice a week for six weeks to see if their balance and mobility would improve when compared with the pre and post scores from the Performance Oriented Mobility Assessment (POMA). The participant’s scores on the Performance Oriented Mobility Assessment showed an average increase in both gait and mobility from 24 to 27.5 on the post-test. These participants’s were also asked to provide qualitative feedback on their experience in the study. One participant stated that she “gained confidence.” As a whole, the participants really enjoyed playing the Nintendo Wii© Bowling. This study demonstrates that Nintendo Wii© Bowling game can be an enjoyable, easy activity to motivate elders to become more active and social while incorporating exercise into their routine. It also provides the chance for future research to be conducted on older adults to examine the benefits of exercising with the Nintendo Wii© Bowling game.

There is an increase in uncivil student behaviors in the classroom setting including inattention, lying, cheating, and plagiarism. The purpose of this quantitative descriptive study was to determine behaviors that undergraduate nursing students perceived as uncivil in the classroom. The research question was, “How do undergraduate nursing students perceive uncivil behavior in the classroom?” A convenience sample using cluster sample method of all five undergraduate baccalaureate nursing student cohorts from a College of Nursing in Appalachia were invited to complete the researcher’s edited version of the Incivility in Nursing Education (INE) survey. There were 526 undergraduate nursing students enrolled in the program. Power analysis estimate of sample size was 222 with a 95% confidence interval; 372 students completed the survey which demonstrated an adequate sample. The sample consisted of 276 females (74.2%) and 84 males (22.6%). Participant ages ranged from 19 to 53 years. The majority of students, 333 (89.5%) were Caucasian. The primary behavior that students perceived as uncivil was holding distracting conversations, 285 (76.6%). The most common uncivil behavior experienced by students was acting bored or apathetic, 318 (85.5%). Challenging faculty, 232 (62.4%) was the most common uncivil behavior reported by students. Students perceived academic incivility as a problem, 260 (69.9%). Data from this study support previous findings that incivility in the nursing academic environment is a serious and growing problem. These findings are important because the instructor is responsible for providing a classroom environment that is conducive to learning. Classroom interventions are suggested to provide a healthier learning environment.

As the United States population becomes more culturally diverse, it has become a priority for health care professionals to competently provide culturally sensitive care. Cultural competency is required in baccalaureate (BSN) programs, mandated by collegiate nursing accrediting agencies. Although BSN programs have integrated cultural competency education into their core curricula, little data has been collected evaluating outcomes and effectiveness. Using a 36 question survey, students in all levels of a selected BSN program were asked questions regarding cultural competency and attitudes towards cultural care. The ANOVA and a Tukey Kramer analyses were performed with an alpha coefficient of 0.05 and a confidence interval of 95%. The results revealed some statistically significant differences between several cohorts. Additionally, Cohort 5 (students in the last semester of the nursing program) did not differ significantly to Cohorts 2,3, and 4, indicating that current cultural competency education may not be adequate or effectively taught as students progress through the BSN program.

Two types of patient-centered care in the radiology profession are service and safety. Service relates to the technologist being a patient advocate by effectively communicating, building relationships and providing care. Two types of safety in the radiologic sciences profession relate to contrast media and radiation safety. The focus of this study was on radiation safety. The project was designed to evaluate exposure indicator values from radiographic procedures performed by junior and senior radiography students during the month of March 2013. The mean exposure indicator values for radiographic procedures were evaluated by all students and then by student rank (juniors and seniors). The type of procedure and student rank (juniors and seniors) had an impact on exposure indicator values. The results revealed that dose creep occurred during radiographic procedures performed by student radiographers. It was determined that there is a need for additional education for student radiographers regarding selection of appropriate exposure factors to minimize dose creep.

The purpose of this study was to examine how past experiences with nursing homes influence perceptions and attitudes of college students toward nursing homes in the United States. A review of the current research literature indicates that nursing homes are publicly scrutinized in a negative manner. Variables examined included students’ college of study, experience with nursing homes either from personal experience, from a well-known relative or friend, or the media, and different attitudes and perceptions including good or bad views of nursing homes. Results indicate that students’ perceive nursing homes more negatively than positively even when their experience came from personal knowledge. Students enrolled in health services do not perceive nursing homes more positively than negatively or any better than students enrolled in other courses of study. Moreover, there was no significant relationship between the students’ perceptions of nursing homes and their field of study.

Cognitive decline increasingly plague older adults. Although various studies have correlated aerobic exercises with decreased incidence of the development and progression of cognitive deterioration in older adults, there is no evidence as to whether or not the Wii Fit Plus Rhythm Kung-Fu, Hula-Hoop and the Wii Just Dance can improve the cognitive function of older adults as measured by the Standardized Mini Mental State Examination (SMMSE) instrument. A descriptive study design was used to explore the feasibility of implementing an aerobic exercise program for older adults in an assisted living facility using these Wii games, and evaluating whether or not older adults enjoyed playing the games. A sample of N =5 participants in the East Tennessee region of Appalachia completed the study in an assisted living facility. The games lasted from 5-20 minutes per session, twice a week for four weeks. Pre/post descriptive analysis of survey questions suggested that the sample enjoyed playing the games and these games may be feasible to implement in future studies. However, a larger, randomized, controlled research study is needed to further investigate the effect of these games on the cognitive status of this population.

With healthcare reform on the rise and the population of Baby Boomers increasing exponentially, nurses are in higher demand than ever before. Students in nursing school are under a great deal of stress as they balance a heavy academic load with outside responsibilities to jobs and families. These stressors often carry into professional practice, resulting in nurses that are constantly stressed. This study asks nursing students about their perceived stress and about the specific ways they cope with their stress. The study’s results show that most students wish they had more time to engage in stress relieving activities. When students and nurses do not have time to adequately relieve their stress, their patients may be adversely affected. Stressed nurses are more prone to making careless mistakes, which can negatively impact the quality of patient care. This problem is compounded by the projected shortage of registered nurses. Nursing students need to be educated early on about constructive stress coping mechanisms that will carry into their practice. Nursing programs and employers can help promote effective coping by establishing policies that create positive, lower-stress learning and work environments. Implications of such policies and specific results of this study will also be discussed.