Medicine and Health Sciences Commons^™

The Impact Of Kentucky’S Medicaid Expansion On Adult Coverage And Diagnosis Of Type 2 Diabetes Mellitus And Diabetic Peripheral Neuropathy, The Use Of Antihyperglycemics And The Role Of Social Determinants Of Health 2011-2018., Brian Mcroberts

Electronic Theses and Dissertations

Objectives: This study analyzed the impact of Medicaid expansion in Kentucky on coverage of adults aged 19-64 and the diagnosis of type 2 diabetes mellitus (T2DM) and diabetic peripheral neuropathy (DPN) and the use of antidiabetic medications or insulin (antihyperglycemics) for T2DM, controlling for Social Determinants of Health (SDOH). Method: This study assembled ICD-based claims and prescription drug NDC claims from all adult residents of Kentucky enrolled in Medicaid from 2011 to 2018. Three-digit zip code (Zip-3) data was appended to each case from the American Community Survey to provide SDOH variables. Tests performed included ANOVA, decision trees, varimax rotated …

Implementing A Diabetes Risk Screening Protocol In The Primary Care Setting., Anna Marks

Doctor of Nursing Practice Papers

Abstract

Background: Over one-third of the United States population, approximately 86 million individuals, are estimated to have prediabetes (CDC, 2021a). If left untreated, prediabetes will progress to type II diabetes mellitus (T2DM) in approximately 25% of subjects within 3–5 years, and as many as 70% of individuals with prediabetes will develop T2DM within their lifetime (Hostalek, 2019).

Purpose:The purpose of this quality improvement project was to implement and evaluate the American Diabetes Association MyChart Diabetes Risk Assessment tool in a primary care clinic to optimize the early identification of prediabetes and T2DM in non-pregnant adults ages 18 to 70 …

The Association Between Depression And Anxiety With Covid-19 Outcomes., Erica Miller

Electronic Theses and Dissertations

Previous studies have shown that mental disorders affect COVID-19 mortality. This study investigated the effect of depression and/or anxiety on COVID-19 outcomes. Depression/anxiety was defined by actively taking medication and/or diagnosis. The outcomes were ICU admission; ventilation; mortality; and time to mortality. Of 698 hospitalized patients, there were 204 (29%) defined to have either depression or anxiety. There were 109 deaths, and of those, 52 (48%) were diagnosed with depression/anxiety. Multivariable logistic regression and Cox proportional hazards models were used to examine associations. ICU admission and ventilation were not significantly associated with depression/anxiety. Depression/anxiety was associated with mortality (OR: 1.84, …

Trends In Hysterectomy In Hospital And Ambulatory Settings In Kentucky 2017-2020., Felicia A. Pugh

Electronic Theses and Dissertations

Hysterectomy is the most common treatment for benign uterine conditions in the United States. Data suggest that one in nine women will have the procedure in their lifetime (1). Previous studies indicate that abdominal hysterectomy rates for non-malignancies are declining as alternative methods are increasing for decades; however, those trends do not apply for all women in the country (2-5). In this cross-sectional study, hysterectomy procedures completed between 2017-2020 are described in Kentucky Cabinet for Health and Family Services data. Multivariable logistic regression is used to assess the odds of abdominal hysterectomy for benign indications in Kentucky. Conclusion: Rates of …

Particulate Matter Exposure And Community-Acquired Pneumonia Mortality Among Hospitalized Adults With Pneumococcal Pneumonia: Incidence Study (Happi) Participants., Jack Anthony Pfeiffer

Electronic Theses and Dissertations

The role of air pollution as an agent of elevated morbidity and mortality has come under increasingly intense scrutiny in recent years. As the body of literature grows, so too does our understanding of how extensive the harm of such pollutants can be. Particulate matter (PM) particularly harmful due to its small size, ability to travel great distance while airborne, and capacity to infiltrate numerous bodily systems, often to the detriment of those exposed. Besides being associated with increased mortality risk in more heavily exposed populations, PM exposure has also been associated with complications in the respiratory, cardiovascular, and nervous …

Facial Mask Use And Covid-19 Protection Measures In Jefferson County, Kentucky: Results From An Observational Survey, November 5−11, 2020, Seyed M. Karimi, Sonali S. Salunkhe, Kelsey B. White, Sahal A. Alzahrani, Bert Little, William P. Mckinney, Natalie Dupre, Riten Mitra, Yuting Chen, Martha M Popescu, Emily R. Adkins, Julia A. Barclay, Emmanuel Ezekekwu, Caleb.He X. He, Dylan M Hurst, Aravindreddy Kothagadi, Shaminul H. Shakib, Devin N. Swinney, David A. Johnson, Rebecca Hollenbach, Sarah Moyer

The University of Louisville Journal of Respiratory Infections

Introduction: The transmission of respiratory infectious diseases such as COVID-19 can significantly decrease by mask-wearing. However, accurate information about the extent and proper use of the facial mask is scarce. This study’s main objective was to observe and analyze mask-wearing behavior and the level of COVID-19 protection measures in indoor public areas (PAs) of Jefferson County, Kentucky.

Methods: For conducting the observational survey study, targets were indoor PAs, and zip codes were defined as surveying clusters. The number of selected PAs in each zip code was proportional to the population and the total number of PAs in that zip code. …

Preventable Hospitalization Among Type 2 Diabetes Patients In Kentucky Before And After Medicaid Expansion 2010-2017., Turky Jamil Arbaein

Electronic Theses and Dissertations

Objectives: 1) Analyze county level variation in T2DM-PH rates in Kentucky before ACA (2010-2013) and after the ACA (2014-2017). 2) Analyze the relationship between county level socioeconomic factors (income per capita, percentage of uninsured people, percent of urban population, primary care and general preventive offices, population aged 65 and above, median age, household income, percentage in poverty, and unemployment rate ) and county level T2DM-PH rates before (2010-2013) and after (2014-2017) ACA implementation in Kentucky. Method: This research was conducted in two phases: Phase one of this study estimated the county-level PH variation among T2DM patients across eight years (2010-2017), …

Hearing Loss: Investigating The Comfort, Confidence, Knowledge, And Preparedness Of Kentucky School-Based Speech-Language Pathologists., Amanda Matsumoto

Electronic Theses and Dissertations

Due to advances in technology, the number of users with hearing devices have increased. These users are often mainstreamed into classrooms with typical hearing peers. However, even with these devices, speech and language impairments may still persist. This study was conducted to analyze school-based speech-language pathologists’ (SLP) comfort, confidence, knowledge, and preparedness in treating students with hearing loss in Kentucky schools. 48 SLPs practicing in all levels of school including elementary, middle, and high, completed an anonymous online survey through the Qualtrics^® platform. Responses were received from SLPs representing 11 out of the 15 regions throughout Kentucky. Spearman’s rank …

Comparative Spending Of Medicaid Dollars On Child Participants Of Kentucky’S Sobriety Treatment And Recovery Teams Program Versus A Matched Comparison Group., Matthew Thomas Walton

Electronic Theses and Dissertations

Child protective services agencies have long observed the complicating role that parental substance use and addiction plays in cases of child maltreatment. Families who struggle with these problems present unique challenges for child welfare professionals. These families are typically more difficult to engage, more likely to have children removed from the home, and have poorer outcomes when compared to other families. These poorer outcomes often include health problems. Addiction has well-known effects on health, and the specific manifestations of these problems for parents have been documented for years in child protection casework. However, what has been less investigated are the …

Social Determinants Of Health And A Grounded Mixed-Methods Approach To Explain Declining Life Expectancy In Eastern Kentucky : 1980 – 2014., William Renda

Electronic Theses and Dissertations

Trends in life expectancy for the United States from 1980-2014 suggest general improvement overall. However, eastern Kentucky stands out with a cluster of counties experiencing declining life expectancy. Given that life expectancy is an excepted indicator of overall population health, this anomaly in eastern Kentucky warrants investigation. This thesis uses a grounded mixed methods approach to explore this trend across the greater Appalachian region. Content and discourse analysis of interviews with public health and medical professionals in the study area revealed key themes perceived as being related to declining life expectancy, which informed variable selection for regression analysis. Regression models …

Long-Term Dental Outcomes Of The Professional Education Preparation Program., Samuel D. Petersen

Electronic Theses and Dissertations

Introduction: The Professional Education Preparation Program (PEPP) is a health careers pipeline program for Kentucky pre-health students from Health Professional Shortage Area counties and/or racial/ethnic groups underrepresented in the health professions. The purpose of this study was to determine the demographics of the dental PEPP participants and if, post dental school graduation, they were providing care for underserved patient populations Methods: PEPP dental graduates (n=114) had been previously identified. Participants were contacted by phone, asked to participate and then mailed a survey. Survey questions covered personal, practice and patient characteristics, procedures performed, insurance accepted and community outreach. Logistic regression analysis …

Tetanus In An Unvaccinated Amish Woman After A Breech Home Delivery In Kentucky, 2016, Veronica Corcino, Anna Q. Yaffee, Maydelin Pecchio, Mary E. Powell, Forest W. Arnold

Journal of Refugee & Global Health

No abstract provided.

Refugee Health And The Kentucky Global Health Center, Rahel Bosson, Ruth M. Carrico

Journal of Refugee & Global Health

In this University of Louisville Grand Rounds lecture, Drs. Rahel Bosson and Ruth Carrico give an overview of the real struggle of the refugee population and provide an update of the current state of refugee health in Kentucky.

They also provide an overview of the Global Health Initiative at University of Louisville, which includes the follow programs: HIV/AIDs, Refugee Health and Immunization, Vaccine and International Travel and Global Health Research Support.

The talk concludes looking to the future with a comprehensive Global Health Center composed of improving refugee orientation and EMR, healthcare worker education, developing guidelines, and bettering our surveillance …