Medicine and Health Sciences Commons^™

Improving Dental Students' Knowledge And Confidence In Treating Tobacco Use, Victoria Pierce

DNP Projects

Background: Tobacco use can lead to numerous chronic health conditions. Healthcare professionals in the dental field are in a unique position to broach this issue with patients. Research shows that dental students do not feel equipped to provide tobacco cessation care, citing lack of education on the subject among their top reasons for this.

Purpose: The purpose of this project was to evaluate changes in dental students’ knowledge and confidence related to treating tobacco use after participation in an educational intervention about the 5A’s, behavioral counseling, and first-line prescription medications.

Methods: This quality improvement initiative utilized a quasi-experimental survey design …

Dental Outreach In Academic Dental Settings, Tisha Clayborn

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

Creating an effective outreach program in a dental academic setting involves a strategic approach combining educational objectives and community service. This Dental Outreach Program Guide aligns with organizational objectives, contributes to community well-being, and serves as a model for future outreach initiatives in academic dental settings. This program utilizes the PRECEDE-PROCEED planning model to design and evaluate an oral health strategy. This program aims to outline a strategic plan incorporating evidence-based decision-making, data-driven metrics, and a comprehensive roadmap for successful implementation.

Advanced Microstructural Characterization Of Functionally Graded Dental Ceramic Material For Materials-Informed Finishing, Angani Vigneswaran

Theses and Dissertations--Manufacturing Systems Engineering

Yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) has gained popularity as the choice of material for dental prosthetics. Ivoclar Vivadent’s IPS e.max ZirCAD Prime dental ceramic incorporates a unique gradient technology that varies the yttria content over the thickness of the material. The top layer is composed of 5Y-TZP which is desired for its optical properties while the bottom layer is composed of a much stronger 3Y-TZP. In between the two layers, 5Y-TZP and 3Y-TZP are mixed to form a transition layer. Varying the amount of yttria allows for more esthetically pleasing translucency in the visible areas of the restoration without compromising …

Implementing A Mobile Saliva Rinse Screening For P16 Markers For Hpv (Human Papillomavirus) Positive Head And Neck Cancers In Central Kentucky, Madeline Brown

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

Rates of HPV-related head and neck cancers are increasing across the nation and more specifically, there has been a significant increase in the state of Kentucky. This study focuses on the implementation of a mobile clinic saliva-rinse screening program. This program will be set up at UK Athletics Men's basketball and football games in hopes of recruiting middle aged men ages 45-60, who are the target audience of the study. This is the population with highest prevalence for HPV positive head and neck cancers and also the population least likely to visit their health providers regularly. A quick saliva rinse …

Calcium Imaging Of Central Amygdala Activity After Fentanyl Escalation, Samantha Malone

Theses and Dissertations--Psychology

Evidence suggests that rats given long access (LgA) sessions to self-administer (SA) opioids escalate their intake, while also showing greater withdrawal severity and drug-induced reinstatement compared to rats maintained on short access (ShA) daily SA sessions. Little is known about the neural changes that occur during opioid escalation that may impact withdrawal and relapse. Past work examining opioid SA using ShA sessions in rodents has identified the central amygdala (CeA) as an area of interest that becomes hyperactive in acute withdrawal and may be involved in the incubation of craving that occurs after protracted withdrawal. However, these studies have not …

Rapid Scoping Review Of The Epidemiological Evidence For Mercury Exposure And Prevalence Of Alzheimer’S Disease, Rebecca Mattingly

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

This rapid scoping review examines the current body of epidemiologic research evaluating the potential linkage between environmental exposure to mercury and Alzheimer's disease (AD). Alzheimer’s disease accounts for 60-80% of all neurodegenerative disease in the United States and was the seventh leading cause of death in Kentucky in 2020. The exact etiology of AD needs further investigation; however, environmental factors such as pesticides, arsenic, cadmium, lead, and mercury have been correlated with development of AD lesions, cognitive decline, and AD. Mercury is a toxic metal that can be found in air, water, and soil, both from natural and human-made sources. …

Gender Differences In Barriers To Entering Substance Use Treatment, Casey A. Baker

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

Background

Nationally representative data have indicated that less than one in ten individuals with a substance use disorder (SUD) have received recent treatment, suggesting a need for research to examine potential barriers to SUD services. Although research has been conducted to identify some barriers to treatment, there is little research focused on gender differences. To address this gap in research, the present study aimed to examine gender differences in barriers to entering SUD treatment, as well as differences in factors that may impact decisions to enter treatment.

Methods

Participants (N = 62) were recruited from the community as part of …

Effects Of Social Isolation And Adolescent Ethanol Exposure On Adult Drinking And Nicotine Co-Use, Jakob Shaykin

Theses and Dissertations--Psychology

Alcohol use often begins in adolescence and can lead to increased susceptibility to AUD in adulthood. Stress in the form of social isolation during adolescence can also prompt substance use disorders later in adulthood. This thesis determined if exposure to ethanol (EtOH) during adolescence and social isolation alters the trajectory of alcohol and nicotine intake during adulthood. In Experiment 1, adolescent male and female Sprague-Dawley rats were administered intermittent injections of EtOH (2g/kg 20% EtOH, IP) or saline (PND 28-41). EtOH consumption was measured in adulthood (PND 49-55) using a 2-bottle choice procedure where one bottle contained a 0.2% saccharin/15% …

Development Of Zafirlukast Derivatives Active Against Porphyromonas Gingivalis, Kaitlind C. Howard

Theses and Dissertations--Pharmacy

Periodontal diseases are inflammatory diseases that can lead to damage of the soft tissue and bone supporting the teeth. Gingivitis is the reversible early stage of gum disease, which consist of gums that bleed when brushing or flossing teeth. When left untreated, the preventable but irreversible late stage of periodontal disease, periodontitis, can lead teeth to loosen or even fall out. Oral bacterial species, such as the Gram-negative anaerobic pathogen Porphyromonas gingivalis trigger these inflammatory diseases through oral dysbiosis. P. gingivalis is a keystone pathogen, meaning that the damage caused by P. gingivalis is not proportional to its abundance. Treatment …

Evaluation Of A Beverage Educational Intervention For Latino Parents Of Infants And Children Ages Nine Months To Five Years, Natalie Chelf

DNP Projects

Background: The Latino population has the highest rate of childhood obesity in the United States. Sugar-sweetened beverage (SSB) consumption has a positive correlation with increased rates of childhood obesity. Current research shows a deficit in culturally sensitive methods to reduce SSB consumption in the pediatric Latino population.

Purpose: The purpose of this project is to empower parents of Latino infants and young children with the knowledge to reduce or eliminate the consumption of SSBs in their child’s diet.

Methods: The project was a one group pre-test post-test quasi-experimental study design occurring in one pediatric outpatient clinic. The Information-Motivation-Behavioral Skills (IMB) …

Muscle Mass And Immune Function In The Senior Horse, Alisa Christina Herbst

Theses and Dissertations--Veterinary Science

Senior horses (≥ 15 years) represent up to one-third of the global equine population, and the proportion of old horses (≥ 20 years) in the U.S. has been steadily increasing. Aging is associated with a loss of skeletal muscle mass in horses, and while age-related muscle loss is comparingly well characterized in humans, little is currently known concerning underlying mechanisms, adverse outcomes, or the prevalence of low muscle mass in senior horses. One factor proposed to play a role in the development of age-related muscle atrophy in humans is inflamm-aging, a low-grade inflammation that affects elderly people and that has …

Comparison Of Implant-Retained Overdenture And Conventional Complete Denture In The Edentulous Mandible: A Survey Study To Measure Patients' Satisfaction And Quality Of Life In Dental School Clinical Environment, Ahmad Kutkut

Theses and Dissertations--Clinical and Translational Science

Patient satisfaction and quality of life are integral parts of assessing the quality of oral health care. Current aging population trends suggest a growing need to understand the effects of edentulism on oral health and quality of life. As the proportion of aged Americans expands, there will be an increased need to understand treatment options and patient communication strategies. In addition, as new treatment options and innovative technologies emerge, it will be essential to understand patients' concerns and identify best practices associated with denture treatments' individual fit and function. Advanced denture treatments can now be fabricated using CAD/CAM digital denture …

S. Gordonii-Produced Hydrogen Peroxide Modulates Mir-663a And Ccl20 Expression In Oral Epithelial Cells, Marshall Houston Maynard

Theses and Dissertations--Medical Sciences

The mechanisms through which a persistent recognition of commensal bacteria by oral epithelial cells (OECs) mitigates an uncontrolled inflammatory response of the oral mucosa remain unknown. CCL20 secretion by OECs in response to pathogenic bacteria is regulated by S. gordonii (Sg)-induced miR-663a; nevertheless, the mechanisms involved in these Sg-modulated responses remain to be elucidated. Since Sg is a hydrogen peroxide (H₂O₂) producer, and H₂O₂ has been shown to stimulate miRNA expression, we hypothesized that H₂O₂ could be involved in Sg-induced miR663a and CCL20 responses. Expression of miR663a …

The Impact Of Kentucky's Medicaid Expansion Under The Affordable Care Act On Dental Care Visits, Mutlaq Alotaibi

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

Background. Lack of health insurance, cost of dental care services, and shortage of dental workforce are leading barriers to dental care access. Low-income adults and those who reside in areas with low dentist supply are less likely to visits a dental office than their counterparts. Studies have reported that dental visits increased among low-income adults in states that expanded Medicaid under the Affordable Care Act (ACA) and have an adequate number of dentists. However, the impact of Medicaid expansion on income-based disparities and urban-rural disparities in dental care visits is unclear.

Objectives. The aim of this study is to examine …

Exploring The Relationships Between Cultural Values And Diet Patterns Among Mexican And Cuban Immigrants In Kentucky, Nasreen Omran

Theses and Dissertations--Nutrition and Food Systems

The number of Latinx in the U.S. is expected to grow to about 28 percent of the population by the year 2060. As the number of Latinx increases in the U.S. it is important to understand how cultural beliefs influence dietary behaviors as Latinx are disproportionately affected by diet related disease such as diabetes mellitus, cancer, and cardiovascular disease. The aim of this secondary data analysis is to examine the relationship between family values, gender roles, and religious values on diet patterns in adult Mexican and Cuban immigrants in Kentucky utilizing the Mexican American Cultural Values Scale. The study findings …

An Assessment Of The Carrier State And A Novel Marker Of Leptospira And Abortion In Central Kentucky Horses, Gloria Louise Gellin

Theses and Dissertations--Veterinary Science

Leptospirosis is a reemerging zoonotic infection of worldwide importance and affects all mammals. The bacterium is transmitted to animals and humans by urine, fetal membranes and body fluids. Leptospira shedding in the urine contaminates both soil and water, exposing both humans and animals to the bacterium. Leptospirosis in horses can cause abortion and is one of the etiologies of equine recurrent uveitis which can lead to blindness. Equine leptospiral abortion in Central Kentucky is primarily caused by serovar Pomona, with occasional cases attributed to serovar Grippotyphosa. There are a few reports in the literature attributing abortion to serovar Bratislava in …

The Lived Experience Of Hope In The Midst Of Recovery From A Substance Use Disorder: A Phenomenology, Mary Katherine Lance

Theses and Dissertations--Family Sciences

Substance use disorder (SUD) is difficult to treat, as evidenced by its high prevalence and relapse rates. Research shows, however, that hope may have the potential to create effective and efficient change in the way we prevent and treat SUD. In order to utilize hope in this way, we must have a good understanding of what hope is. This phenomenological study aims to explore and describe the essence of hope through the lived experience of individuals in recovery from a SUD. Through interviews with 20 informants to generate data and an iterative interpretative process to identify shared meanings, hope emerged …

Educational Intervention To Change Knowledge And Attitudes Regarding Sexual Behaviors To Reduce Rates Of Sexually Transmitted Infections Among University Of Kentucky’S Sorority Life Students., Julianna Maita

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

Sexually transmitted infections disproportionally affect young adults. Within this age group, women are at an increased risk for contracting and STI and face more severe long-term adverse consequences than men. College aged individuals are at an increased risk for contracting an STI due to risky sexual behaviors such as unprotected sex with multiple partners. College students involved in Greek Life have been found to engage in risker sexual behaviors than non-Greek life students. These individuals perceive themselves to be at a higher risk for contracting an STI and have an increased number of unprotected sexual encounters under the influence of …

The Effect Of The Affordable Care Act On The Ability Of Health Departments In The Appalachian Regions To Offer Primary Care Services, Ogechi Anyagaligbo

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

In the Appalachian region, the need for primary care services has increased due to an increase in morbidity rates from coal mining, obesity, drugs, and poor health care. The Affordable Care Act (ACA) was enacted in part to expand access to patient care. The ACA aimed to help solve these problems and help underdeveloped communities such as the ones in the Appalachian region that do not have access to affordable and quality health care. This project examines differences before and after the ACA was passed on the delivery of primary care services by local health departments within the Appalachian region. …

Epidemiology Of Upper Extremity Injuries In High School Sports, Autumn Ruthe Whitson

Theses and Dissertations--Rehabilitation Sciences

Participation in high school sports has seen a steady increase over the past four decades. With nearly eight million student-athletes participating, careful monitoring of injuries related to their participation is imperative. Injury surveillance efforts through national databases have produced a multitude of studies detailing injuries that occur in specific sports, specific body parts, or particular diagnoses. The lower extremity tends to be injured more frequently than the upper extremity resulting in various comprehensive analyses on that particular body area. Currently, there are no comprehensive reports on the epidemiology of injury to the upper extremity in student-athletes participating in high school …

The Influence Of Physical Health, Emotional Health, And Socioeconomic Factors On The Musculoskeletal Pain Experience In Patients Attending A Pro Bono Physical Therapy Clinic, Garrett Naze

Theses and Dissertations--Rehabilitation Sciences

Non-communicable, chronic diseases are highly prevalent in the United States, reducing the quality of life for those affected and contributing to the majority of the nation’s healthcare expenditure. These conditions include, among others, cardiovascular disease, diabetes, and musculoskeletal disease. Musculoskeletal disease is particularly of interest for the field of physical therapy as the vast majority of patients seeking care in the outpatient setting present with musculoskeletal pain complaints, resulting in limitations in function, participation, and quality of life for the patient.

The factors influencing health outcomes are diverse and include a person’s physical environment, social and economic factors, access to …

Leading Well: Anesthesiology Program Directors As Servant Leaders And Their Development Of Resident Wellness Programs, Amy Noel Dilorenzo

Theses and Dissertations--Education Sciences

Anesthesiology residents are at significant risk of developing serious issues during training including burnout, depression, and substance abuse. Recent accreditation requirements mandate that these well-being issues be addressed by residency training programs. Program directors, as the leaders of residency programs, are charged with protecting the wellness of residents and leading wellness initiatives. The program director role can be well-described in a servant leadership construct because they are charged with caring for the individual needs of their residents.

This dissertation is a report of a mixed-methods study that explores anesthesiology program directors’ self-perceptions as servant leaders and their efforts to lead …

Examining Cultural Influences On Dietary Behaviors Among Mexican Americans With Low Acculturation, Austyn Erickson

Theses and Dissertations--Nutrition and Food Systems

Mexican Americans represent approximately 63 percent of the total Hispanic population in the US and are disproportionately affected by health disparities related to poor nutrition status. With this community among the fastest growing populations in the US, it is critical to address the health disparities and the relationship between culture and diet to provide evidence-based nutrition interventions that are culturally sensitive to specific communities. The purpose of this cross-sectional exploratory study is to examine the relationship between cultural values and dietary behaviors among a low-income, urban, clinical sample of Mexican Americans using the Mexican American Cultural Values Scale, dietary assessment, …

College Campus Outreach To Increase Chlamydia Screenings, Elizabeth Kinney

DNP Projects

A common sexual health concern around the world is sexually transmitted infections (STI). Chlamydia is the most reported sexual health problem. The highest prevalence of chlamydia rates is among ages 15-24, which includes college age students (CDC, 2019). The lack of education provided to students prior to starting college by parents, health care providers and high school sources as well as inaccurate information obtained from peers and erroneous internet sources may lead to misconceptions about STIs and consequently the avoidance of routine screening among this high-risk population (Canan & Jozkowski, 2017).

The purpose of this project was to determine if …

Relationship Between Initial Prescription Opioid Exposure Length And Future Opioid Use Disorder Diagnosis In Opioid Naive Adolescents, Eric Lindahl

Theses and Dissertations--Pharmacy

Objectives: The long-term risks associated with the use of short-term prescription opioids in opioid naïve adolescents in not well characterized. The purpose of this study was to explore the potential association between the days’ supply of the initial prescription opioid exposure and the rates of diagnosed OUD in the subsequent 3-year period. Methods: We conducted a retrospective cohort study using a nationwide database of commercially-insured adolescents aged 12-17 at the time of the index opioid fill. A multivariable Cox Proportional Hazard regression model was developed to analyze the association of interest while accounting for known risk factors for the development …

Establishing Exclusive Breastfeeding And The Influence Of Hospital Support, Martha Monroe

Theses and Dissertations--Nursing

Maternal-child health authorities recommend that infants breastfeed exclusively for the first six months of life. Currently, 25% of infants in the United States do so. Breastfeeding specific care that mothers receive from their postpartum nurses and lactation specialists is integral to successfully initiating exclusive breastfeeding. Due to the time sensitive nature of establishing milk supply, interrupting the process of lactogenesis with supplementation puts infants at high risk for early termination of breastfeeding. The purpose of this dissertation is to examine the relationship of breastfeeding care received during the postpartum hospital stay, defined as the first 48-72 hours of life, and …

Community Collaborations For Health Improvement In Laurel County, Kentucky: A Case Study, Kendall Ferrell

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

Kentucky is currently ranked fifth in the United States for opioid-involved overdose deaths. This study assesses how the results of a community health needs assessment have developed collaborative community effort to create and expand services and programs to address opioid and substance use disorder in Laurel County, Kentucky. This particular community continues to rank opioid and substance abuse as a major health concern causing efforts to be put in place to create an opioid response program. A consortium was formed that developed the community health needs assessment survey. The results from the survey were then incorporated in to a strategic …

Utilizing Cdc Framework For Program Evaluation To Inform Assessment Of An Interprofessional Leadership And Teamwork Curriculum, Madeline Aulisio

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

Background
The ability to collaborate effectively and lead a team when the need arises has become an expectation of health professionals. Graduates of health professions programs are expected to possess skillsets that will allow them to both collaborate and lead effectively in addition to their profession-specific knowledge. Leadership Legacy, an interprofessional elective created at the University of Kentucky in 2009, was designed to address this need.

Methods
After nearly ten years of cohorts, an opportunity arose for program evaluation with a reliable method such as the Centers for Disease Control and Prevention Framework for Program Evaluation. The novel use of …

Analysis Of High Potency Anticholinergic Prescribing In Scottish Nursing Home Patients, Alexandra Nugent

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

Purpose: The aim of this study was to compare the use of two or more high-potency anticholinergic (HPA) medications between patients 65 years and older in nursing homes and in the greater community using prescribing data. Methods: This secondary data analysis of the NHS Scotland PIS databased used prescription data from a nationally representative patient-level database. Patients were included were ≥65 years old, received ≥2HPA prescriptions from 2011Q2-2012Q1(11/12), 2016Q1-2017Q2(16/17), 2018Q2-2017Q1(18/19). The principle endpoint of this study was to assess for a change in patient’s relative risk of receiving ≥2HPA prescriptions. Results: 29,301 patients were identified. From 11/12 to 16/17 all …

Improving Colorectal Cancer Screening Rates In Perry County, Vashisht Madabhushi

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

Appalachian Kentucky has one of the highest incidence and mortality rates from colorectal cancer (CRC) in the country. CRC is curable if identified early through screening. However, Perry County has suboptimal screening levels. A multimodal program of patient reminders and mailed screenings will be used to increase CRC screening rates in Perry County. The primary outcome will be evaluated using a T-test for this prospective cohort study. Short term outcomes include increased CRC screening rates in delinquent patients. Long term outcomes include increased CRC detection rates and decreased CRC mortality in Perry County.