Digital Commons Network^™

Image Anaysis For Predicting Body Weight In Humans, Jeffrey S. Barrett, Chee Ng

Pharmaceutical Sciences Faculty Patents

Systems and methods for determining body weight predictions and human conditions are disclosed. A body weight may be predicted by capturing at least one image of a human, and determining, from the image, a body weight prediction of the human by processing the at least one image with a data processor. The body weight prediction may further be based on an age-based weight factor. A model such as a neural network model may be used to predict body weight.

A Virginia Mountain City Responds To The Challenge Of Improving Health Outcomes, Robert S. Cowell Jr.

Journal of Appalachian Health

In 2012, Roanoke Virginia was becoming a city of haves and have-nots, a place where many were benefitting from revitalization underway but too many were seeing their situation grow worse and becoming even more entrenched. Poverty with levels as high as 50% in some neighborhoods; life expectancy sometimes 14 years shorter than those living just one or two neighborhoods over; and lack of access to fresh food, medical care, and economic opportunities—all within view of the largest hospital in the region was unacceptable.

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Altered Gating Of KV1.4 In The Nucleus Accumbens Suppresses Motivation For Reward, Bernadette O'Donovan, Adewale Adeluyi, Erin L Anderson, Robert D. Cole, Jill R. Turner, Pavel I. Ortinski

Neuroscience Faculty Publications

Deficient motivation contributes to numerous psychiatric disorders, including withdrawal from drug use, depression, schizophrenia, and others. Nucleus accumbens (NAc) has been implicated in motivated behavior, but it remains unclear whether motivational drive is linked to discrete neurobiological mechanisms within the NAc. To examine this, we profiled cohorts of Sprague-Dawley rats in a test of motivation to consume sucrose. We found that substantial variability in willingness to exert effort for reward was not associated with operant responding under low-effort conditions or stress levels. Instead, effort-based motivation was mirrored by a divergent NAc shell transcriptome with differential regulation at potassium and dopamine …

Main And Regional Campus Assessments Of Applicants To A Rural Physician Leadership Program: A Generalizability Analysis, Terry D. Stratton, Clarence Kreiter, Carol L. Elam

Behavioral Science Faculty Publications

While the selection of qualified applicants often relies, in part, on scores generated from a medical school pre-admission interview (MSPI), the growth of regional medical campuses (RMCs) – many with specialized rural tracks, programs, or missions – has challenged schools to accommodate a wider range of stakeholder input. This study examines the reliabilities of main (urban) and regional (rural) campus interviewers’ assessments of applicants to a Rural Physician Leadership Program (RPLP) located in the southeastern United States.

Data from RPLP applicants completing MSPIs on two campuses from 2009-2017 (n = 232) were examined in a generalizability analysis. In two separate …

The Role Of The Community Health Delivery System In The Health And Well-Being Of Justice-Involved Women: A Narrative Review, Sharla A. Smith, Glen P. Mays, Tracie C. Collins, Megha Ramaswamy

Health Management and Policy Faculty Publications

Background: Over seven million imprisoned and jailed women are released into the community each year and many are ill-equipped to meet the challenges of re-integration. Upon release into their community, women are faced with uncertain barriers and challenges using community services to improve their health and well-being and reuniting with families. Few studies have identified and described the barriers of the community health delivery system (CHDS)- a complex set of social, justice, and healthcare organizations that provide community services aimed to improve the health and well-being (i.e. safety, health, the success of integration, and life satisfaction) of justice-involved women. We …

Epidemiologic Evaluation Of Nhanes For Environmental Factors And Periodontal Disease, P. Emecen-Huja, H. -F. Li, J. L. Ebersole, J. Lambert, Heather M. Bush

Biostatistics Faculty Publications

Periodontitis is a chronic inflammation that destroys periodontal tissues caused by the accumulation of bacterial biofilms that can be affected by environmental factors. This report describes an association study to evaluate the relationship of environmental factors to the expression of periodontitis using the National Health and Nutrition Examination Study (NHANES) from 1999–2004. A wide range of environmental variables (156) were assessed in patients categorized for periodontitis (n = 8884). Multiple statistical approaches were used to explore this dataset and identify environmental variable patterns that enhanced or lowered the prevalence of periodontitis. Our findings indicate an array of environmental variables were …

Opening Doors For Health Disparities Research In Appalachia, Frances J. Feltner, Mace Baker, Kentucky Homeplace, University Of Kentucky

Center of Excellence in Rural Health Presentations

Rural Appalachian communities in eastern Kentucky suffer from some of the nation’s most severe health disparities and barriers to health care. Communitybased research can be an effective way to address health disparities and promote equitable access to care by identifying problems and sharing workable solutions. However, significant challenges exist for successful recruitment and retention of research participants because rural Appalachian populations can be difficult to reach.

Kentucky Homeplace (KHP) is a nationally-recognized Community Health Worker (CHW) program established in 1994 by the University of Kentucky (UK) Center of Excellence in Rural Health (CERH) in Hazard. KHP is an invaluable and …

Network Analysis Approaches To Collaborative Information Seeking In Inter-Professional Health Care Teams, J. David Johnson

Communication Faculty Publications

Introduction: It is widely believed that interprofessional health care teams can improve patient care and increase safety; however, intra-team communication has often proven to be problematic. One particularly important aspect of this problem is how teams collaborate to seek the information needed to address the issues they are confronting. Network analysis offers a rich set of concepts for tackling this problem.

Method: Review essay.

Analysis and results: Network analysis approaches offer the promise of more nuanced approaches and diagnostic tools that could address these issues by focusing on its elements: reciprocity, centrality, density, fault lines, multi-team systems, …

Teach Students, Empower Patients, Act Collaboratively And Meet Health Goals: An Early Interprofessional Clinical Experience In Transformed Care, Maria Gabriela Castro, Melanie Dicks, Keisa Bennett, Carol Hustedde, David Sacks, Lynn Joyce Hunter, William Elder

Family and Community Medicine Faculty Publications

Purpose: Transformation of care teaching is often didactic and conceptual instead of practical and operational. Clinical environments, slow to transform, limit student exposure to key experiences that characterize transformed care. We describe the design and implementation of TEAM Clinic (Teach students, Empower patients, Act collaboratively, Meet health goals) – an early clinical learning experience to address this gap.

Methods: The TEAM Clinic curriculum was based on a review of existing curricula and best practice recommendations for the transformation of care. Three key elements were selected as the focus for a low-volume, high-service clinic: patient centeredness, interprofessional collaboration and team-based care. …

Associations Between Slc16a11 Variants And Diabetes In The Hispanic Community Health Study/Study Of Latinos (Hchs/Sol), Bertha A. Hidalgo, Tamar Sofer, Qibin Qi, Neil Schneiderman, Y. -D. Ida Chen, Robert C. Kaplan, M. Larissa Avilés-Santa, Kari E. North, Donna K. Arnett, Adam Szpiro, Jianwen Cai, Bing Yu, Eric Boerwinkle, George Papanicolaou, Cathy C. Laurie, Jerome I. Rotter, Adrienne M. Stilp

Epidemiology and Environmental Health Faculty Publications

Five sequence variants in SLC16A11 (rs117767867, rs13342692, rs13342232, rs75418188, and rs75493593), which occur in two non-reference haplotypes, were recently shown to be associated with diabetes in Mexicans from the SIGMA consortium. We aimed to determine whether these previous findings would replicate in the HCHS/SOL Mexican origin group and whether genotypic effects were similar in other HCHS/SOL groups. We analyzed these five variants in 2492 diabetes cases and 5236 controls from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), which includes U.S. participants from six diverse background groups (Mainland groups: Mexican, Central American, and South American; and Caribbean groups: Puerto Rican, …

Effectiveness Of Prophylactic Lingual Strengthening Exercises For Patients With Head And Neck Cancer A Systematic Review, Cassidy Pickens

Theses and Dissertations--Communication Sciences and Disorders

Radiation treatment for head and neck cancer has devastating effects on swallowing ability. Prophylactic swallowing exercises are often recommended. However, the evidence for these exercises is equivocal and information regarding critical components of an exercise program is lacking. The purpose of this systematic review was to examine the evidence regarding lingual strengthening exercises as a component of a prophylactic swallowing program.

The Effect Of Narrative Medicine Combined With Medication Assisted Treatment On Decreasing The Desire To Use Intravenous Substances In Hospitalized Patients With Infective Endocarditis, Paula Works

DNP Projects

Substance abuse is a significant problem that spans the nation. Of particular concern is the growing population of patients at UK HealthCare who have endocarditis as a complication from IV substance abuse.

PURPOSE: The aims of this study were

1. To assess the effect of narrative medicine combined with MAT, compared to MAT alone, on desire to use in hospitalized patients with a history of IV substance use
2. To examine the changes in quality of life before and after the introduction of narrative medicine in hospitalized patients with a history of IV substance abuse using The Quality of Life Scale (QOLS). …

Emergency Room Services Used By Pediatric Patients Who Have An Established Primary Care, Rebecca J. Cooksey

DNP Projects

Background: The use of emergency room services for primary care issues is an ongoing problem. The incidence is higher in the Medicaid population and is associated with emergency room overcrowding and excessive medical costs.

Purpose: The purpose of this study was to explore the extent of and the details surrounding non-acute emergency room visits in a pediatric population within an urban primary care clinic.

Methods: This was a two-part descriptive study with both quantitative and qualitative components. A retrospective chart review of this facility’s ER data constituted the quantitative descriptive part of the study. The qualitative arm of the study …

Incidence And Treatment Of Acute Sinusitis In Two Outpatient Primary Care Settings And Provider Challenges In Treating Adult Sinusitis, Britney Nicole Perkins

DNP Projects

Abstract

BACKGROUND: Nationally, approximately one third of antibiotics are currently being prescribed unnecessarily. Antibiotic misuse can result in disability, longer hospital stays, increased costs to organizations, antibiotic resistance and death.

PURPOSE: The purpose of this project was two-fold: (1) explore current management of acute adult rhinosinusitis in an outpatient setting (2) assessing providers perceptions on the barriers to preventing antibiotic misuse.

METHODS: A retrospective chart review of 150 charts was performed to examine prescribing practices by providers treating rhinosinusitis at two primary care practices. An interview was conducted with the practice providers on barriers for compliance in antibiotic stewardship.

RESULTS: …

Reducing Infant Mortality Through The Nurse Family Partnership Home Visitation Program In Montgomery County, Alabama, Kristyn Hill

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The mitigation of infant mortality (IM) has long been a public health effort within the United States. And although the rates have dramatically decreased with medical advancements, certain populations remain disproportionately affected. There are various factors that are thought to contribute to our IM rates and the disparities between women of varying demographics. Alabama has the highest rates of infant mortality in our county, and women of color within the state have even higher rates.

Many programs with goals of decreasing the IM rate within the United States have been implemented over time. In particular, home visitation programs have been …

Factors That Influence Maternal Feeding Decisions For Toddlers: Extending The Theory Of Planned Behavior, Elizabeth Lucas Combs

Theses and Dissertations--Kinesiology and Health Promotion

Establishing healthy eating behaviors is vital in the early years to help combat the development of obesity and other chronic diseases. Mothers play an invaluable role in shaping their children's eating habits through controlling what and when children eat as well as the overall food environment, which is why a better understanding of what influences mothers’ decisions about these behaviors is important.

The purpose of the dissertation was to gain a better understanding of what impacts maternal feeding decisions regarding toddler nutrition behaviors. This was a two-phased mixed methods study. The aim of the initial study was to explore, using …

A Comprehensive Assessment Of Crisis In Individuals With Intellectual Disabilities And Its Implications For Physical Therapy, Kathleen Sutton

Theses and Dissertations--Rehabilitation Sciences

Advancements in medicine, policy, and societal attitudes have improved life expectancy, socialization, and participation for individuals with intellectual and developmental disabilities (IDD). However, inconsistent or a lack of services may drive healthcare utilization toward expensive emergency care services. This can negatively impact health outcomes and disrupt physical therapy treatment plans, limiting their effectiveness and further placing individuals with IDD at risk for crisis episodes. Because of its subjective nature, quantifying crisis is challenging using current definitions. Rehabilitation professionals are often active members of the care team for individuals with IDD, however no evidence currently exists regarding how the profession can …

Trends And Patterns In Use Of Medications For Opioid Use Disorder In A Commercially Insured Population In The U.S., Catherine Serratore

Theses and Dissertations--Pharmacy

Opioid use disorder (OUD) and opioid overdose are pervasive public health problems in the U.S. Medications for opioid use disorder (MOUD) have been shown effective to reduce OUD morbidity and mortality. Two distinct approaches to MOUD are currently used: agonist therapy (methadone or buprenorphine) or antagonist therapy (naltrexone). Limited information is available about the patterns of use, adherence to therapy, and characteristics of those who use agonist vs. antagonist therapy. The objective of this study is to assess recent trends in MOUD, adherence in use of MOUD, and the characteristics of those who use agonist vs. antagonist therapy in a …

2018 Kentucky Dental Workforce Update, Sydney P. Thompson, Melissa Slone, Frances J. Feltner

Center of Excellence in Rural Health Workforce Reports

The perception that oral health is in some way less important than and separate from general health has been deeply ingrained in the American consciousness. Many Americans are unaware of ways to preserve oral health and may not recognize signs indicating they are in trouble. Poor oral health can contribute to various diseases including endocarditis, cardiovascular disease, diabetes, HIV/AIDS, osteoporosis, and Alzheimer’s disease.

Kentuckians often fair worse on a multitude of health measures, especially rural Kentuckians. According to the 2019 County Health Rankings data, when compared to US averages, Kentuckians are more likely to smoke (18% vs 23%), be obese …

Culminating Experience In The Application Of Biostatistics In Public Health: A Report On My Consultation Experiences, Samantha Kennedy

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Executive Summary

This portfolio is a compilation of three different consulting experiences that I have had to opportunity to work with as a part of University of Kentucky’s Master of Public Health program with a concentration in biostatistics. My portfolio consists of project descriptions, notes, reports, relevant SAS code and output, and other supporting materials for the three projects I worked with. Each of the projects that I worked with were vastly different, as was my role in them. As such the supporting documents for each are very different as well, but each does have a brief description of the …

A Comparison Of Pediatric Prevention Policies To Pediatric Health Supervision Codes, Rania Burke

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The number of policy statements from the AAP presents pediatricians with an increasing amount of advice related to prevention, yet the definition of prevention and well-child visits has not changed for outpatient office visits. Outpatient office visits are the primary means by which preventive care is administered. The objective of this study is to quantify and characterize the prevention policy recommendations that pediatricians are expected to provide patients/guardians beyond the well-child visit. Secondarily, an analysis was completed to demonstrate which prevention policies make recommendations that can be coded for reimbursement as part of a well-child prevention visit.

METHODS The author …