Digital Commons Network^™

Chronic Illness And Mental Health Issues, Marlene B. Huff, Kimberly K. Mcclanahan, Hatim A. Omar

Pediatrics Faculty Publications

By 2015, worldwide, 1.2 billion children aged 5-14 years will have some kind of significant chronic disease. Although scientific evidence indicates that children with chronic illness have more mental health issues than their healthy peers, many controversies and gaps in the literature exist. It is imperative that an understanding of the effects of chronic illness upon the mental health status of children and adolescent be undertaken. This article uses a biopsychosocial perspective to investigate the connection between chronic illness and mental health. The intent of the article is to suggest ways that medical and mental health professionals can provide services …

Educating Adolescents About Puberty: Are We Missing Something?, Hatim A. Omar

Pediatrics Faculty Publications

Adolescents undergo significant physical and cognitive changes during their pubertal development. These changes contribute to and impact their future development. Educating adolescents at an early age about their expected development decreases the possible anxiety associated with this period of life and also helps adolescents make better choices in regards to their sexuality. In order to assess the degree of education regarding pubertal development and sexuality, we conducted a survey of late adolescents (median age 19 years) and parents of adolescents. A total of 409 adolescents (237 females, 172 males) and 124 parents completed the survey. 14.4% of teens (36.6% of …

Mental Health Aspects Of An Adolescent Medicine Clinic Patient Population, Abdel Salous, Linah Al-Alem, Hatim A. Omar

Pediatrics Faculty Publications

The correlation between exposure to forms of violence and development of mental disorders in victims is well established. The purpose of this chapter was to identify mental health problems in an adolescent medicine clinic population in Lexington, KY and to investigate potential correlation of mental disorders with psychosocial factors. Data were gathered from the charts of 169 adolescent clinic patients (age 10-22) seen in the clinic for mental health care and analyzed using Excel. 68% of the patient population was urban, while 32% was rural. In terms of gender, 40% of the patients were male and 60% were female. 80% …

Quality Of Life And Adolescents In Rural Kentucky, Hatim A. Omar, Søren Ventegodt, Joav Merrick

Pediatrics Faculty Publications

In many rural areas in Kentucky, adolescents lack the basic assets for a good quality of life, such as having caring adults, a safe place and useful activities after school. In this chapter we analyze data from middle and high school students referred to a comprehensive school based health promotion center (SBHPC). From August 2006 to February 2008, a total of 382 students (200 female, 182 male, aged 12-18 years) were referred to the SBHPC for help. Only two (0.5%) students had two parents living with them and 12 (3.1 %) had safe, organized after school activities. 19.9% of the …

The Vampire Adolescent, Megan White, Hatim A. Omar, Joav Merrick

Pediatrics Faculty Publications

No abstract provided.

Quality Of Life And Persons With Intellectual Disability: Can We Measure Qol In This Population?, Søren Ventegodt, Hatim A. Omar, Flemming Struve, Tove K. Nielsen, Isack Kandel, Joav Merrick

Pediatrics Faculty Publications

Quality of life (QOL) has been discussed by professionals working with persons with intellectual disability (ID) for some time, but since QOL is concerned with subjective well-being, satisfaction and happiness, how is it possible to measure, when the person in question is unable to communicate? Consciousness is believed to be an internal and personal thing, but we have done the simple experiment to ask observers to rate QOL of another person, also in sub dimensions like self-assessed physical and mental health, relationship with self, self-assessed sexual ability, self-assessed social ability, and we have found that people are able to assess …

Prepubertal Office Gynecology, Hatim A. Omar, Wendy Jackson, Amit M. Deokar

Pediatrics Faculty Publications

Clinical presentation and complaints of the vulvo-vaginal area are quite prevalent in the pediatric population and the primary care providers the first individuals called upon to evaluate the patients. One of the most difficult tasks for an individual that rarely performs the genitourinary examination is performing one on a pediatric patient. This chapter has been written to aid the primary care provider in successful examination, documentation and diagnosis.

Ovarian Tumors In Children And Adolescents, Linah Al-Alem, Amit M. Deokar, Rebecca Timme, Hatim A. Omar

Pediatrics Faculty Publications

Ovarian tumors are uncommon in the child and adolescent population, but given that cancer is a leading cause of death even in this age group it is important for the general practice physician to be aware of the signs and symptoms. These can include abdominal pain, increased abdominal girth, a palpable mass on pelvic or abdominal exam, nausea and vomiting, decreased appetite, weight loss, constipation, back pain, leg cramps, dyspareunia, urinary symptoms, abnormal uterine bleeding, and ascites, to name a few. The types of gynecological tumors seen in adults are also seen in children except in differing frequencies. The most …

Contraception, Donald E. Greydanus, Hatim A. Omar, Lyubov A. Matytsina, Artemis Tsitsika

Pediatrics Faculty Publications

Contraception is an important concept for sexually active adolescent females to understand who do not wish to become pregnant. This chapter reviews important, effective, and safe contraceptive methods that can be used by female youth. These methods include abstinence, oral contraception, contraceptive patch. mini-pills, emergency contraceptives, injectable contraception (DMPA), implants (lmplanon), intravaginal ring, vaginal barrier contraceptives, intrauterine devices, and natural family planning. Promotion of sexual responsibility should be the charge of health professionals caring for adolescents and young adults.

Breast Disorders In Children And Adolescents, Donald E. Greydanus, Hatim A. Omar, Lyubov A. Matytsina, Artemis Tsitsika

Pediatrics Faculty Publications

Concerns about problems of the breast are often noted in adolescents and their parents. This review discusses issues and disorders of the breast in children and adolescents, starting with basic principles of embryology and adolescent breast development. Concepts that are covered include congenital breast disorders, abnormal timing of breast development, breast asymmetry, underdeveloped breasts, breast atrophy, tuberous breasts, mammary hyperplasia, fibroadenoma, giant fibroadenoma, cystosarcoma phyllodes, intraductal breast papilloma, adenocarcinoma, mastitis, traumatic breast disorders, benign breast disease, fibrocystic change, mastalgia, gynocomastia, and galactorrhea. A number of figures are provided illustrating breast pathology. Clinicians caring for children and adolescents are encouraged to …

Menstrual Disorders In Adolescent Females, Donald E. Greydanus, Hatim A. Omar, Artemis Tsitsika, Dilip R. Patel

Pediatrics Faculty Publications

Onset of menstruation (i.e., menarche) is a determining event of the adolescent female signifying the progress of puberty, which in the majotity of cases is visibly initiated with thelarche (onset of breast development or breast buds). Menarche usually occurs during the earlier time of the second decade of life and ends with menopause, typically in the 5th decade of life. The adolescent can present with a wide variety of menstrual dilemmas and disorders which will be discussed in this chapter.

The Impact Of Wyeth V. Levine On Fda Regulation Of Prescription Drugs, Richard C. Ausness

Law Faculty Scholarly Articles

On March 4, 2009, the United States Supreme Court decided Wyeth v. Levine. In that case, the Court concluded that the plaintiff's failure to warn claim against the makers of the drug Phenergan was not impliedly preempted by the Food, Drug and Cosmetic Act (FDCA). In doing so, the Court rejected the argument of the U.S. Food and Drug Administration (FDA) that tort claims of this nature stand as an obstacle to federal regulatory objectives. This article evaluates the Court's opinion in Wyeth and examines that decision's impact on subsequent litigation in the area of prescription drug labeling. In …

Conditional Spending And Compulsory Maternity, Nicole Huberfeld

Law Faculty Scholarly Articles

More than forty-six million Americans are uninsured, and many more are seeking government assistance, which makes congressional spending for federal programs a significant issue. Federal funding often comes with prerequisites in the form of statutory conditions. This Article examines the impact that conditions placed on federal healthcare spending have on the individuals who rely on that spending by exploring the ongoing disconnect between Spending Clause jurisprudence and women's reproductive rights. The first Part reviews the foundational Supreme Court precedents and places them in context from both a statutory and theoretical perspective. The second Part studies what the author denominates "pure …

A Behavioral Approach To Human Rights, Andrew K. Woods

Law Faculty Scholarly Articles

For the last sixty years, scholars and practitioners of international human rights have paid insufficient attention to the ground level social contexts in which human rights norms are imbued with or deprived of social meaning. During the same time period, social science insights have shown that social conditions can have a significant impact on human behavior. This Article is the first to investigate the far-ranging implications of behavioralism—especially behavioral insights about social influence—for the international human rights regime. It explores design implications for three broad components of the regime: the content, adjudication, and implementation of human rights. In addition, the …

Drug Law Reform—Retreating From An Incarceration Addiction, Robert G. Lawson

Law Faculty Scholarly Articles

Now, thirty years into the "war on drugs," views about the law's reliance on punishment to fix the drug problem are less conciliatory and more absolute: "[t]he notion that 'the drug war is a failure' has become the common wisdom in academic ... circles." Those who have most closely studied the results of the "war" believe that it has "accomplished little more than incarcerating hundreds of thousands of individuals whose only crime was the possession of drugs." More importantly, they believe that it has had little if any effect on the drug problem: "Despite the fact that the number of …

Vegetarians And Vegans In Kentucky, Danita Martha Hines

University of Kentucky Master's Theses

Kentucky has a health crisis and most of the causes can be linked to diet, smoking and physical activity. Vegetarian and vegan diets have numerous benefits for many diet related health problems such as obesity, heart disease, Type 2 diabetes and certain cancers. There has been limited research on vegetarians and vegans in the United States and none in Kentucky. This study used an anonymous electronic survey to examine the different characteristics, behaviors, experiences and opinions of adult vegetarians and vegans in Kentucky. Results were compared to statistical data reported on the general population of Kentucky. Calculated body mass index …

Dietitians’ Use And Perceptions Of Nutrition Screening Tools For The Older Adult, Sarah Ross Small

University of Kentucky Master's Theses

Malnutrition is a significant issue affecting the health of many adults over the age of 65. Screening for malnutrition in this population can help identify those in need of a complete nutritional assessment. Many screening tools have been developed to aid healthcare team members in identifying those at risk for malnutrition. A population of dietitians with a focus in older adult nutrition was surveyed to determine dietitians’ perceptions and use of screening tools for the older adult. The results of the study showed many dietitians did not use validated screening tools at their place of work and were not confident …

The Relationship Between Obesity And Skin And Soft Tissue Infections, Juliana Swiney

MPA/MPP/MPFM Capstone Projects

The Problem:

It is well known that our country is experiencing an obesity epidemic: 33.9% of all adults are obese (BMI>30) and 67% of adults are either overweight or obese (BMI>25). Obesity is a risk factor for several serious disease states such as, diabetes, stroke, hypertension, heart disease and some types of cancer. It also has a less well defined relationship with skin and soft tissue infections.

Although it is known that excessive weight increases the opportunity for harmful skin conditions, this relationship has not been as well studied. Some of the mechanisms that predispose obese people to …

Radical Hysterectomy With Pelvic Lymphadenectomy: Indications, Technique, And Complications, Rachel A. Ware, John R. Van Nagell Jr.

Obstetrics and Gynecology Faculty Publications

Radical hysterectomy with pelvic lymphadenectomy remains the treatment of choice for women with Stages IA₂ and IB₁carcinoma of the cervix, and selected patients with Stage II endometrial cancer. Improvement in surgical techniqe, administration of prophylactic antibiotics, thromboemolic prophylaxis, and advances in critical care medicine have resulted in lower operative morbidity associated with this procedure. Major urinary tract complications such as ureteral injury or vesico-vaginal fistula are now extremely rare (< 1%). Five-year survival rates following this procedure vary according to a number of clinical and histologic variables, and may be as high as 90% in women without lymph node metastases.

How Does Background And Training Affect Dance Pedagogy In Higher Education?, Meredith Erin Sims

University of Kentucky Master's Theses

Dance faculty in higher education have various backgrounds and training ranging from professional dance careers to doctoral degrees in dance. This study sought to examine the ways background and training impact faculty members‟ pedagogical approach to a dance technique class in a higher education dance department. This study examined the pedagogical knowledge, content knowledge, and pedagogical content knowledge of participants through qualitative methods including interviews, observations, and document analysis. Six major themes emerged from the data: desire to teach, teaching focus, challenging students, planning and preparation, instructional methods, and assessment strategies.

Splendor In The Bluegrass: The Policing Of Drug Related Crime In Lexington, Kentucky, Christine Elizabeth Smith

University of Kentucky Master's Theses

This project is designed as a case study investigating the relationship and practices between residents and police officers in the William Wells Brown neighborhood of Lexington, Kentucky toward the issue of drug-related crime. Employing Michel Foucault‘s work on governmentality and his concept of Splendor, I explore how governance is practiced within the daily negotiations of the WWB neighborhood. I approach this project through the lens of policing because some residents, especially those who comprise the William Wells Brown Neighborhood Association, form a limited partnership with the police department in combating the threat of drug crime in the neighborhood. Drug-related crime …

Injury-Induced Hand Dominance Transfer, Kathleen E. Yancosek

University of Kentucky Doctoral Dissertations

Hand dominance is the preferential use of one hand over the other for motor tasks. 90% of people are right-hand dominant, and the majority of injuries (acute and cumulative trauma) occur to the dominant limb, creating a double-impact injury whereby a person is left in a functional state of single-handedness and must rely on the less-dexterous, non-dominant hand. When loss of dominant hand function is permanent, a forced shift of dominance is termed injury-induced hand dominance transfer (I-IHDT).

Military service members injured in combat operation may face I-IHDT following mutilating injuries (crush, avulsion, burn and blast wounds) that result in …

Yersinia Pestis Virulence Factor Yopm Undermines The Function Of Distinct Ccr2+Gr1+ Cells In Spleen And Liver During Systemic Plague, Zhan Ye

University of Kentucky Doctoral Dissertations

Yersinia pestis, the infective agent of bubonic and pneumonic plague, is classified as a category A agent of bioterrorism. YopM, a protein toxin of Y. pestis, is necessary for full virulence in a systemic plague mouse model with ambient-temperature grown bacteria. We used this model to identify the cells undermined by YopM. Natural killer (NK) cells were previously reported to be lost in spleen and blood in a YopM-associated way; however, NK cell depletion was found not to occur in liver, and ablation of NK cells had no effect on bacterial growth, indicating that NK cells are redundant …

Arsenite Oxidation By Pure Cultures Of Thiomonas Arsenivorans Strain B6 In Bioreactor Systems, Aniruddha Dastidar

University of Kentucky Doctoral Dissertations

The removal of arsenic toxicity from water is accomplished by a preliminary preoxidative step transforming the most toxic form, arsenite (As (III)), to the least toxic form, arsenate (As (V)). The potential of As (III) oxidation to As (V) was initially investigated in batch reactors using the chemoautotrophic Thiomonas arsenivorans strain b6 under varying initial As (III) and cell concentrations and at optimal pH and temperature conditions (pH 6.0 and temperature 30°C). The strain b6 completely oxidized As (III) to As (V) during exponential growth phase for lower levels of As (III) concentrations (≤ 100 mg/L) but continued into stationary …

Nm23-H1 Blocks Cell Motility Independently Of Its Known Enzymatic Activities In A Cohort Of Human Melanoma Cells, Joseph Robert Mccorkle

University of Kentucky Doctoral Dissertations

The metastasis suppressor gene NM23-H1 has been shown to possess three enzymatic activities including nucleoside diphosphate kinase, histidine-dependent protein kinase and 3’-5’ exonuclease activity. While these properties have been demonstrated in vitro using recombinant proteins, the contribution of these activities to suppression of metastatic dissemination is unknown. Site-directed mutagenesis studies were used to identify amino acid residues which are required for proper function of each enzymatic activity associated with H1, providing a platform for studying the importance of each function on an individual basis. To assess the relevance of these activities to melanoma progression, a panel of mutants harboring selective …

Analysis Of The Crmp Gene In Drosophila: Determining The Regulatory Role Of Crmp In Signaling And Behavior, Deanna Hardt Morris

University of Kentucky Doctoral Dissertations

The mammalian genome encodes five collapsin response mediator protein (CRMP) isoforms. Cell culture studies have shown that the CRMPs mediate growth cone dynamics and neuron polarity through associations with a variety of signal transduction components and cytoskeletal elements. CRMP is also a member of a protein family including the presumably ancestral dihydropyrimidinase (DHP) protein that catalyzes the second step in pyrimidine degradation. In Drosophila, CRMP and DHP proteins are produced by alternatively spliced transcripts of the CRMP gene. The alternative protein forms have a 91% sequence identity, but unique expression patterns. CRMP is found exclusively in neuronal tissues and …

Immobilization Of Mercury And Arsenic Through Covalent Thiolate Bonding For The Purpose Of Environmental Remediation, Lisa Y. Blue

University of Kentucky Doctoral Dissertations

Mercury and arsenic are widespread contaminants in aqueous environments throughout the world. The elements arise from multiple sources including mercury from coal-fired power plants and wells placed in natural geological deposits of arseniccontaining minerals. Both elements have significant negative health impacts on humans as they are cumulative toxins that bind to the sulfhydryl groups in proteins, disrupting many biological functions. There are currently no effective, economical techniques for removing either mercury or arsenic from aqueous sources. This thesis will demonstrate a superior removal method for both elements by formation of covalent bonds with the sulfur atoms in N,N’-Bis(2-mercaptoethyl)isophthalamide (commonly called …

The Cost Of Medication Errors In The Emergency Department: Implications For Clinical Pharmacy Practice, Benjamin Bowman

MPA/MPP/MPFM Capstone Projects

Introduction

The main purpose of this capstone project is to provide an objective analysis of the cost of a medication error in the emergency department. The secondary objective of this analysis is to estimate the cost avoidance impact of providing clinical pharmacy services in the emergency department (ED).

Literature review

Previous literature has described the scope of clinical pharmacy services in the ED and has, to some extent, presented economic outcomes analyses of the impact of these services (Cohen et al., 2009; Lada and Delgado, 2007). According to Cohen et al., the current literature is still lacking a formal pharmacoeconomic …

Community Needs Assessment Of Mayasandra Village, Karnataka, India, Alexander Hernandez Holl

MPA/MPP/MPFM Capstone Projects

No executive summary.

Factors Affecting The Success Of Robinson Scholars, Amanda Michele Dunn

MPA/MPP/MPFM Capstone Projects

The Robinson Scholars Program was created by the University of Kentucky Board of Trustees as an effort to combat historically high rates of poverty and low rates of educational attainment in Kentucky’s Appalachian region. The first class was selected in 1997 and was part of a broader effort to improve community and economic development in eastern Kentucky.

The Robinson Scholars Program provides financial and academic support for potential first-generation college students from the program’s 29-county service area. Scholars are selected in the eighth grade and are provided with enrichment opportunities and college preparation activities throughout their high school careers. Once …