Digital Commons Network^™

Use Of Topical Nsaids In Acute Musculoskeletal Sports Injury: A Brief Review, Amit M. Deokar, Shawn J. Smith, Hatim A. Omar

Pediatrics Faculty Publications

The objective of this chapter is to summarize the current standards of pain management in minor sports-related musculoskeletal injuries. This chapter also addresses the topical form of non-steroidal anti-inflammatory drug as an effective pain management option in an outpatient setting. Design: Quantitive systematic review of randomized controlled trials. Methods: The data was obtained through literature review of articles published in the last 10 years. In addition, FDA information on non-steroidal anti-inflammatory medications was also reviewed. The patient population studied in the articles included children and adults. Conclusion: Current standards of managing pain resulting from sports injuries involve a number of …

Concepts Of Contraception For Adolescents With Obesity: Pathways Of Judicial Moderation, Donald E. Greydanus, Hatim A. Omar, Artemis Tsitsika

Pediatrics Faculty Publications

All sexually active youth, whether obese or normal weight, should be offered counseling regarding contraception and appropriate contraceptive methods. However, obese youth who are sexually active may be less likely than their normal weight peers to use contraceptives correctly. Methods of contraception for obese adolescents are reviewed in this discussion. Combined oral contraceptives (COCs) and the contraceptive patch have higher failure rates in obese versus normal weight females, though failure rates are lower than noted with barrier contraceptives. The risk for venous thrombosis is higher in obese youth on COCs. Progestin-only pills and the levonorgestrel intrauterine system appear to be …

Ethics And Holistic Healthcare Practice, Michael De Vibe, Erica Bell, Joav Merrick, Hatim A. Omar, Søren Ventegodt

Pediatrics Faculty Publications

The paper aims to contribute to integrated discussion of ethics in holistic healthcare. Methods: Noting key aspects of the literature on ethics in holistic healthcare, the authors then focus on describing the working ethical statement for holistic healthcare practitioners produced for the International Society of Holistic Health (ISHH). Ethical principles, aims of holistic practice, and ethical guidelines are presented. The relationship of ethics to quality of care is outlined. Conclusions: The authors conclude that many of the ethical principles and guidelines, as well as expectations of quality and safety, that apply to mainstream healthcare, also apply to holistic practitioners. However, …

Obesity And Hyperandrogenism, Amit M. Deokar, Shawn J. Smith, Amanda J. Goodwin, Hatim A. Omar

Pediatrics Faculty Publications

This chapter has a two-fold objective. One, it addresses the association of hyperandrogenism and obesity and the complex metabolic derangements that are part of the problem. Clinical management of these co-morbidities is challenging and complex. Second, this article will aid health care providers with the key features to an early diagnosis and intervention to decrease the morbidities in the short as well as long term. Method: Systematic review of articles and information on the topic of interest that were published in the last 15 years. Conclusion: Obesity and hyperandrogenism are integral parts of Metabolic Syndrome/Polycystic Ovarian Syndrome (PCOS)/Hyperandrogenism, Insulin resistance, …

Obesity And Lack Of Physical Activity, Hatim A. Omar, Efrat Merrick-Kenig, Joav Merrick

Pediatrics Faculty Publications

Lack of physical activity and overweight status continues to be a significant health problem in the United States. To assess the actual prevalence of these problems, we reviewed data from the School-based Health Promotion Centers in one middle school, and one high school in central Kentucky. A total of 232 6th graders and 607 9th graders were included. A total of 92% of 6th graders and 45% of 9th graders reported complete lack of regular exercise. 37% of 9th graders and 59% of 6th graders had inappropriate nutrition, 47% of 9th graders and 33% of 6th graders had Body Mass …

Psychological And Social Development, Kimberly K. Mcclanahan, Marlene B. Huff, Hatim A. Omar

Pediatrics Faculty Publications

The global epidemic of childhood and adolescent overweight has become a major public health concern. Not only are these youth more likely to become obese as adults, and thus more prone to obesity-related diseases than their non overweight peers, they are also likely to suffer emotional and social effects associated with overweight. Overweight in youth has been linked to depression, low self-esteem, eating disorders, negative body image, and stigma. It appears to be bi-directional in nature, with overweight sometimes predicting certain psychological effects and psychosocial issues sometimes predicting overweight. Effective assessment and treatment of psychological and mental health issues in …

Product Liability's Parallel Universe: Fault-Based Liability Theories And Modern Products Liability Law, Richard C. Ausness

Law Faculty Scholarly Articles

Strict liability has always been the heart and soul of American products liability law. As early as 1963, Justice Roger Traynor in Greenman v. Yuba Power Products, Inc. stated that "[a] manufacturer is strictly liable in tort when an article he places on the market, knowing that it will be used without inspection for defects, proves to have a defect that causes injury to a human being." Shortly thereafter, the drafters of section 402A of the Restatement (Second) of Torts made it clear that the exercise of due care would not shield sellers from liability when their products caused injury. …

Evaluation Of Dietary Alterations That Have Potential To Affect Feed Intake And Feed Preference In Swine, James Seth Monegue

University of Kentucky Master's Theses

Feed intake is a key factor affecting pig performance; thus, the objective of these studies was to assess a variety of factors that could potentially affect intake in pigs in different production stages. Studies were conducted to determine the effects of flavor and diet complexity, Appetein™ (an alternative protein source), and graded levels of salt on swine feed intake and feed preference. Two newly developed flavors were used in nursery pig diets. The use of the two flavors did not increase feed intake (P > 0.05). Nursery pigs actually showed a preference for the control diet. Complex diet formulation does increase …

Insights Into Expression, Cellular Localization, And Regulation Of Supernatant Protein Factor, A Putative Regulator Of Cholesterol Biosynthesis, Elzbieta Ilona Stolarczyk

University of Kentucky Doctoral Dissertations

SPF (Supernatant Protein Factor) is a cytosolic protein that stimulates at least two enzymes in the cholesterol biosynthetic pathway: squalene monooxygenase and HMGCoA reductase. The mechanism of action has not been established but may be related to lipid transfer between intracellular membranes.

There are three human genes for SPF: SEC14L2 (SPF1), SEC14L3 (SPF2) and SEC14L4 (SPF3). The present study differentiates these closely related genes by evaluating their tissue-specific and relative expression levels. SPF1 mRNA was found to be most abundant in liver, mammary gland and stomach. SPF2 showed negligible expression in all tissues tested; SPF3 expression pattern was similar to …

Evaluating The Effects Of Organic And Conventional Inputs On Soil Chemical And Biological Properties In A Four-Year Vegetable Rotation And The Investigation Of Soil Microbial Properties On Plant Gene Expression, Audrey Law

University of Kentucky Doctoral Dissertations

The objective of this research was to determine the effects of conventional inputs on soil chemical and biological properties compared to organic systems in a four year vegetable rotation. Tillage and cover crops were the same in all treatments to avoid confounding factors often present in similar research. Additional experiments investigated plant gene expression in organic and conventional management systems and in soils with decreased microbial diversity. Experimental plots were prepared in the spring of 2004; four replications of three management treatments, organic, low-input and conventional, were arranged in a randomized complete block design. The rotation consisted of edamame soybean, …

The Pharmacogenomics Of Egfr-Dependent Nsclc: Predicting And Enhancing Response To Targeted Egfr Therapy, Justin M. Balko

University of Kentucky Doctoral Dissertations

The introduction of tyrosine kinase inhibitors (TKI) targeting the epidermal growth factor receptor (EGFR) inhibitors to the clinic has resulted in an improvement in the treatment of non small cell lung cancer (NSCLC). However, many patients treated with EGFR TKIs do not respond to therapy. The burden of failed treatment is largely placed on the healthcare field, limiting the effectiveness of EGFR TKIs. Furthermore, responses are hindered by the emergence of resistance. Thus, two questions must be addressed to achieve maximum benefit of EGFR inhibitors: How can patients who will benefit from EGFR TKIs be selected a priori? How …

Biology And Management Of The Bed Bug, Cimex Lectularius L. (Heteroptera: Cimicidae), Alvaro Romero

University of Kentucky Doctoral Dissertations

The near absence of bed bugs from human dwellings for fifty or more years has left us with limited knowledge of its biology and few answers to eliminate populations. I explored a diverse set of objectives to answer key questions concerning bed bug biology and control. Major objectives were studies of circadian rhythmicity, pyrethroid resistance, sublethal effects of insecticides, synergism of pyrethroids, and evaluation of a pyrrole insecticides, chlorfenapyr. Additional studies included persistence of Borrelia in bed bugs after ingestion, and aggregation factors from feces.

In the absence of host stimuli, insects were much more active in the dark than …

An Empirical Analysis Of The Utilization Patterns Of Within Facility And Secondary Healthcare Services By Kentucky State Prison Inmates, Sandra Jane Winter

University of Kentucky Doctoral Dissertations

The inmate population is increasing, aging and generally in poorer health than the non-incarcerated population. Providing healthcare to inmates is constitutionally mandated, and expensive. Little published research exists to assist corrections health policy makers strategically plan for future inmate healthcare needs. This research provides an extensive description of the healthcare utilization patterns of a sample of 577 male and female inmates incarcerated at state-operated prisons in Kentucky during the period January 1, 2007, to December 31, 2007 and who have at least one of the chronic conditions of diabetes, hypertension or hyperlipidemia. The primary outcome measures were a count of …

Role Of Oxidative Stress And T Cell Homing In The Development Of Murine Syngeneic Graft-Versus-Host Disease, Jacqueline Perez-Rodriguez

University of Kentucky Doctoral Dissertations

Syngeneic graft-versus-host disease (SGVHD) is induced by reconstituting lethally irradiated mice with syngeneic BM cells followed by a 21 day treatment with the immunosuppressive agent cyclosporine A (CsA). Clinical symptoms of the disease appear 2-3 weeks following cessation of CsA therapy and disease-associated inflammation occurs primarily in the colon and liver.

The development of SGVHD is a complex process resulting from the cooperative interaction of multiple effector cell populations including NK cells, T cells and macrophages. T_H1 cytokines (IL-12, TNF-α, IFN- γ), produced by these effector cells, serve as inflammatory mediators contributing to the pathogenesis of SGVHD. The …

Proximal Sciatic Nerve Intraneural Ganglion Cyst, Karin R. Swartz, Dianne Wilson, Michael Boland, Dominic B. Fee

Neurosurgery Faculty Publications

Intraneural ganglion cysts are nonneoplastic, mucinous cysts within the epineurium of peripheral nerves which usually involve the peroneal nerve at the knee. A 37-year-old female presented with progressive left buttock and posterior thigh pain. Magnetic resonance imaging revealed a sciatic nerve mass at the sacral notch which was subsequently revealed to be an intraneural ganglion cyst. An intraneural ganglion cyst confined to the proximal sciatic nerve has only been reported once prior to 2009.

Understanding The Development Of Infant Feeding: A Spectral Analysis Approach, Pooja Vijaygopal

University of Kentucky Master's Theses

Feeding problems in preterm neonates stem from complications of early delivery. Attainment of independent feeding is a prerequisite for Neonatal Intensive Care Unit (NICU) discharges. Some quantitative studies of infant feeding involve excessive amounts of time for data processing. Multivariate spectral analysis was used to minimize time for investigation of variability in these rhythms. Auto and Cross-spectral parameters of the rhythms were correlated with Gestational Age (GA), Postmenstrual Age (PMA), Birthweight (BW), Days of Life (DOL), and Time Since First Nipple feeding (TSFN). Auto-spectral analysis showed 25.55% increase in Bandwidth of suck (bw-su) for a 2-week increase in GA (DOL …

Growth And Stability Of Local Government Taxes: An Analysis Of The Lexington-Fayette Urban County Government’S Tax Revenue Portfolio, Nathan Phelps

MPA/MPP/MPFM Capstone Projects

Adequate tax revenues are critical for a government to operate and maintain the delivery of services that its citizens depend. The stability of these revenues is necessary for a government to accurately forecast future revenue growth and to ensure that balanced-budget requirements are met. The Lexington-Fayette Urban County Government (LFUCG) depends upon five primary tax sources for nearly 95% of its tax revenue. These taxes comprise the city’s tax revenue portfolio and include the business net profits tax, employee withholdings tax, franchise tax, insurance premiums tax, and the property tax. Each of tax possesses unique characteristics that dictate their susceptibility …

Sustainability Significance: An Analysis Of A Community Assessment Survey Distributed By The Bluegrass Regional Planning Council, Kyle Scott

MPA/MPP/MPFM Capstone Projects

PURPOSE:

To analyze information gathered from community leaders and representatives to assist the Bluegrass Regional Planning Council (BRPC) in understanding how the policy issue of sustainable development is prioritized and perceived locally and regionally.

BACKGROUND:

The BRPC conducted a survey as a response to growing interest in the planning community involving sustainable development and more specifically the adoption of sustainable development code. Sustainable development is being defined as “meeting the needs of the present without compromising the ability of future generations to meet their own needs.”1 A. How do public officials and other community representatives prioritize sustainability among other policy …

A Participant Model: Predictive Medical And Behavioral Factors Of Prostate Cancer Screening Attendees At Markey, Shana L. Steinbach

MPA/MPP/MPFM Capstone Projects

Problem Statement

The Prostate Cancer Screening Program at the Markey Cancer Center co-sponsors prostate cancer screenings with the Prostate Cancer Education Council. All participation, including African-American attendance, has decreased 38% from years 2006 to 2008 and program managers are seeking insight to improve program participation by acquiring knowledge of behavioral and medical characteristics that may influence screening attendance. Because of the higher incidence of prostate cancer in African-American men (ACS, 2008), a specific program goal is also to increase screening attendance for this minority population.

Research Strategy

Questions that assess participant behavior, personal, and family medical history are analyzed to …

Image Of God: Effect On Coping, Psycho-Spiritual Well-Being And Fear Of Recurrence In Early Breast Cancer Survivors, Judith Anne Schreiber

University of Kentucky Doctoral Dissertations

The purpose of this dissertation was to examine whether a breast cancer survivor’s view of God influences her religious coping strategies, depression, anxiety, stress, fear of recurrence, and psychological well-being. These variables were selected based on literature that demonstrates relationships among them for breast cancer survivors. The specific aims of this dissertation were to: 1) identify religious coping strategies common to each of the four views of God; 2) examine the relationship of psychological well-being (Ryff) and religious coping strategies; and 3) examine differences in depression, anxiety, stress, fear of recurrence, and psychological well-being among women holding various views of …

Influences Of Supplementing A Mannan Oligosaccharide Containing Product To Pig Diets On Sow And Weanling Pig Performance, I-Fen Hung

University of Kentucky Master's Theses

The objective of these studies was to evaluate the effect of supplying mannan oligosaccharides (MOS) to pig diets on both weanling pig and sow performances.

Nursery pigs challenged with LPS to stimulate an immune challenge had increased body temperature and respiratory rate as well as elevated serum cortisol and TNF-α concentration, MOS-supplemented pigs had a lower rectal temperature and respiratory rate which implied that MOS improves some aspect of the immune function of piglets.

MOS supplementation in sow diets during late gestation and lactation had no effect on litter size, but the piglets from MOS-fed sows were heavier at birth …

The Implementation Of The Kentucky Transitions: A Money Follows The Person Demonstration Grant Program, Amie Goodin

MPA/MPP/MPFM Capstone Projects

Kentucky Transitions is a Kentucky Medicaid program that is funded primarily by a grant from the Centers for Medicare and Medicaid Services. The purpose of this program is to transition individuals residing in long-term care facilities back into the community, where they will continue to receive health, social, and other benefits but do so in an approved residential setting. Individuals living in the community may experience higher quality of life and the increased ability to choose how and when they receive services, while Medicaid reaps the projected financial benefit of providing less-expensive community alternatives for care.

Though Kentucky Transitions operates …

Medication Therapy Management: Is It Worth Medicare’S Time?, Jennifer White

MPA/MPP/MPFM Capstone Projects

Problem:

Medication Therapy Management (MTM) is a service that a pharmacist can provide to any of their patients, but mostly to those who are either high risk patients for adverse events or those who are new to chronic medication therapy. As Medicare Part D has begun to cover MTM services, more and more pharmacists and other clinicians are becoming providers of MTM.

The intent of MTM is to decrease adverse events and healthcare costs to both the patient and the third party payer. In realizing the benefits of MTM, it is important to assess these outcomes to see if clinical, …

The Relative Effect Of Alternative Regulatory Actions: Benchmarks For The Compliance And Discipline Process In Different Jurisdictions And Occupations, Robert J. Mcatee

MPA/MPP/MPFM Capstone Projects

The compliance processes of many regulatory agencies have recently come under close scrutiny. The media have portrayed the compliance and discipline processes of many regulatory agencies as being inefficient and not timely in many instances. The Council of Licensure, Enforcement, and Regulation (CLEAR) intends to assist regulatory agencies to do their work in a more efficient and timely manner by providing them with adequate and helpful information.

In the spirit of CLEAR’s mission, a collaborative effort was embarked upon by CLEAR staff and leadership, professionals with experience in the compliance and discipline process along with myself to produce a survey …

Physician Recruitment At Highlands Regional Medical Center: What Works?, Sarabeth Blankenship

MPA/MPP/MPFM Capstone Projects

There is a physician shortage in eastern Kentucky because older physicians are retiring, and younger physicians are choosing to practice in more urban, affluent areas. Eastern Kentucky is plagued with persistent poverty and lacks cultural amenities. These facts put together myths regarding rural practice create a shortage.

My research consisted of interviewing twenty physicians currently practicing at Highlands Regional Medical Center in Prestonsburg, Kentucky. I created a survey instrument that asked questions of physicians regarding demographics characteristics, medical school attended, and what motivated them to practice at Highlands. I chose Highlands because I was able to get interviews scheduled with …

Employability After Substance Abuse Treatment In Kentucky: An Analysis Of The Kentucky Treatment Outcome Study, Steven Scrivner

MPA/MPP/MPFM Capstone Projects

Public funding of substance abuse treatment (SAT) in Kentucky dates back to the 1950s when legislators sought to curb the problem of alcoholism through legislative acts. The definition of substance abuse expanded through the years to include other substances such as cocaine, marijuana and opiates.

Employment after SAT is a critically important outcome for policymakers to consider when allocating funds because it assists in social re-integration, helps to prevent relapse and promotes economic self-sufficiency. Because of this, employment is an important factor to consider when assessing the impact SAT has on its clients (participants).

The Kentucky Alcohol and Other Drug …

An Impact Study Of Locally-Designed Head Start Program Models On Children's Assessment Scores, Jennifer Price

MPA/MPP/MPFM Capstone Projects

Head Start, a nationwide early childhood program, promotes the development and use of locally-designed program models, such as partnerships with child care centers, to expand enrollment opportunities and improve service delivery to eligible children and families. Partnerships are considered to be an efficient solution with positive benefits accruing to the Head Start grantee, partnering child care center, and participating families. It is not known, however, whether partnerships differ from standard, direct-managed centers in terms of promoting school readiness among children, the goal of Head Start. This study addresses that question, undertaking an assessment of the impact, if any, that program …

Promises We Have Kept: Using Grounded Theory Methodology To Understand Developmental Factors That Contribute To Caucasian Low-Income Parents Positive Assessment Of Marital Health, S. Greg Thompson

University of Kentucky Doctoral Dissertations

Low-income Caucasian married parents described lifespan processes and conditions that contributed to their individual assessments that their marriage was healthy. Spouses participated in an interview together, followed later by an individual interview with each. Interview scripts referenced the study‘s primary research questions which sought their reflections on (a) external conditions that they considered to be important to their development, and (b) personal thoughts, emotions and behaviors they deemed relevant to the success of their marriage. A third research question called for integration of participants‘ reflections into a cogent grounded theory regarding successful low-income marriages. Analysis incorporated grounded theory methods, and …

Cell Phones Pose A Distraction To Drivers But Legislative Ban Is Not The Answer, Annie Barret Wallin

Kentucky Law Journal

No abstract provided.

Widespread Panic: Why The Mortgage Lending Industry Can Calm Down About Amending Cramdown, David T. Newton

Kentucky Law Journal

No abstract provided.