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Anti-Inflammatory And Analgesic Effects Of Highly Selective Microsomal Prostaglandin E2 Synthase-1 (Mpges-1) Inhibitors, Madeline Stewart

Theses and Dissertations--Pharmacy

Lipid messenger prostaglandin E2 (PGE₂) is a prostanoid that plays a key role in the generation of the inflammatory response. Currently available non-steroid anti-inflammatory drugs (NSAIDs) inhibit cyclooxygenase (COX)-1 and/or COX-2, all with significant cardiovascular, cerebrovascular, and gastrointestinal risks that have limited their utilization. Microsomal PGE₂ synthase 1 (mPGES-1), an inducible enzyme responsible for overproduction of PGE₂, may be a more promising target for a new type of anti-inflammatory drug without the adverse effects associated with the COX-1/2 inhibition. There have been extensive efforts to design and discover inhibitors targeting mPGES-1. Unfortunately, within the previously …

Prevalence Of Multimorbidity In The Atherosclerosis Risk In Communities Study At Baseline, Katie Highfill

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

Aim: The aim of this study is to examine the prevalence of multimorbidity among middle-aged adults in the Atherosclerosis Risk in Communities Study at baseline by examining the demographic and socioeconomic characteristics of the participants.

Methods

I included 15,698 participants from the Atherosclerosis Risk in Communities (ARIC) baseline visit. Participants were randomly selected from 4 different locations in the United States. Multimorbidity was defined as the prevalence of 2 or more chronic conditions in an individual. Three different multimorbidity definitions (MM1, MM2, and MM3) were created with different inclusion criterion. Prevalence of each multimorbidity definition was analyzed among participants using …

Real-Time Surveillance Of The Drug Epidemic: An Assessment And Comparative Visualization Of Substance Abuse In The Commonwealth Of Kentucky, Julia Van Hosen

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

The purpose of this study was to implement and examine a new surveillance system for Kentucky State Police’s forensics unit to track trends of illicit drugs and drug trafficking, and to see if the implementation of this new system was associated with a decrease in overall drug counts over a period of five months. An extensive review of the literature showed that the drug epidemic in the United States continues to worsen, with public health and law enforcement institutions leading the fight in attempting to end the epidemic, but little evidence showing these two joining forces to work together.

Results …

"Disparities In Suicide Mortality Among Healthcare Support Workers In The United States, 2003-2019", Sol Ngam

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

Objectives: To identify differences in demographic and contextual characteristics of suicide mortality among healthcare support workers (HCSWs) and to estimate annual suicide rates among HCSW in the United States from 2003-2019 using the National Violent Death Reporting System (NVDRS) and the United States Bureau of Labor Statistics (BLS).

Methods: Demographic variables of healthcare support worker suicide decedents were collected using the NVDRS. Odds ratios for circumstantial risk factors by sex were calculated. Crude rates for healthcare support worker suicide decedents were calculated and compared to the U.S. general population suicide crude rates.

Results: Male HCSW were more likely to have …

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 …

Moving Toward And Accessing Adult-Oriented Rehabilitation Therapy Services For Adults With Lifelong Disabilities: A Tale Of Three Studies, Catherine Gohrband

Theses and Dissertations--Rehabilitation Sciences

The aim of this dissertation was to explore how adults with a Lifelong Disability (LLD) access and experience rehabilitation therapy services across their lives. Many LLD diagnoses such as cerebral palsy and spina bifida are considered non-progressive; however, there are common challenges that occur as people with LLD become adults, including increased pain, fatigue, and functional loss. Literature addressing the needs of people with LLD to access adult-oriented medical providers has focused primarily on medical transitions, which have described the processes for pediatric patients moving to adult-oriented settings from pediatric settings. Few studies have addressed the rehabilitation therapy needs of …

Blood Flow Restrictive Training Following Medial Patellofemoral Ligament And Anterior Cruciate Ligament Reconstruction Rehabilitation, Richard Watson

Theses and Dissertations--Rehabilitation Sciences

Both patellofemoral dislocation and anterior cruciate ligament (ACL) ruptures have a significant impact on an athlete’s ability to regain function and return to play. Surgical repair of the medial patellofemoral ligament (MPFL) and ACL ligament reconstructions result in a sequala of quadriceps weakness. Persistent quadriceps weakness following reconstruction can create a cascade effect of muscular atrophy and weakness resulting in significant knee and leg impairments. An abundance of research has shown that blood flow restrictive training (BFRT) has demonstrated significant results in post-surgical rehabilitation by increasing muscular strength and improving function. What is unclear is the effect of deflating or …

Developing Ecologically Valid Clinical Tools For Persons With Tbi: Understanding The Role And Impact Of Distractions, Deanna Pinnow

Theses and Dissertations--Rehabilitation Sciences

There is a critical need for the development of ecologically valid clinical tools to assess real-life cognitive functioning in persons impacted by traumatic brain injury (TBI). Chronic cognitive impairments that are exacerbated by distractions are one of the core factors contributing to poor home and community re-integration post injury. Simulation-based digital platforms (i.e., virtual reality, augmented reality, and mixed reality) have become potential solutions for eliciting real-world cognitive performance in clinical settings. Yet, there is a paucity of research investigating the role and impact of distractions on cognition. As a result, there is no clear framework of measuring distractions to …

Consequences Of Shift Work And Job-Related Exposure On Sleep And Musculoskeletal Outcomes In Structural Firefighters, Jacob Dennis Jelmini

Theses and Dissertations--Rehabilitation Sciences

Firefighting is considered one of the most dangerous occupations in the workforce. Musculoskeletal injuries are consistently the most frequent, and most costly, documented non-fatal injuries in the firefighting setting. An increase in job stress, job exposure, and deprived sleep secondary to job-related duties are plausible explanations for the frequency in musculoskeletal injury. The aims of this dissertation were to ascertain not only how occupational exposure via firefighter emergency call volume may influence outcomes contributing to job stress and objective and subjective sleep metrics, but also its influence on the incidences of musculoskeletal pain.

The results showed that emergency call volume …

Internalized Homonegativity And The Mental Health Of Lesbian, Gay, And Bisexual Individuals: An Integrative Treatment Approach, David Kearby

DSW Capstone Projects

Lesbian, gay, and bisexual individuals (LGBI) have a higher rate of mental health disorders than the general population. The mental health disparities experienced by LGBI are positively correlated with higher internalized homonegativity (IH) levels, which impacts their functioning at the unconscious, cognitive, and interpersonal levels. Thus, effective interventions targeting the mental health of LGBI must consider IH's intrapsychic, cognitive, and interpersonal nature. An integrative psychotherapy approach addressing the mental health and IH of LGBI is needed to address the intrapsychic, cognitive, and interpersonal factors at play.

Product one of this capstone is a systematic literature review that identified psychotherapeutic interventions …

Three Essays On Health, Food, And Agricultural Economics, Saber Feizy

Theses and Dissertations--Agricultural Economics

This dissertation comprises three distinct but interrelated projects that explore the intersection of agriculture, nutrition, and economics. The first project investigates the impact of Community Supported Agriculture (CSA) food programs on the health outcomes of its participants. Using fixed effects models and a matching algorithm, the study finds that while conventional fixed effects models indicate a significant effect of CSA participation on diet-related medical expenditures, our modified time-heterogenous fixed effects model did not find a meaningful effect. The results of the matching method are consistent with those of our modified model.

The second project examines racial disparities in the prevalence …

Consumers’ Preferences And Willingness To Pay For Value-Added Dairy Products In Kentucky - Considering Price, Provenance, And Environmental Product Attributes, Favour E. Esene

Theses and Dissertations--Agricultural Economics

Many medium and smaller dairies are shifting to various kinds of value-added products that may expand in demand nationally aside from fluid milk. This study uses a latent class logit model to investigate the heterogeneity of consumer preferences and willingness to pay for dairy value-added products across four latent classes considering different local and environmental sustainability labels. The dairy products examined for this research are butter, cheese, yogurt, and ice cream. This research revealed that younger consumers, especially those that reside in rural areas, always pay attention to product attributes when they shop for dairy products, mostly the local state …

Interactive Association Of Posttraumatic Stress Disorder, Apolipoprotein Ε4 Genotype, And Age On Cognitive Functioning, Karen A. Lawrence, Colton Rippey, Bianca Welikson, Robert H. Pietrzak, Thomas G. Adams Jr.

Psychology Faculty Publications

Background: The ε4 allele of the apolipoprotein (APOE) gene and posttraumatic stress disorder (PTSD) are associated with cognitive deficits. Both associations may vary depending on age. No previous study has examined a possible three‐way interaction between APOE ε4, PTSD, and age on cognitive functioning.

Methods: Data were analyzed from 1244 European‐American U.S. military veterans who participated in the 2011 National Health and Resilience in Veterans Study (NHRVS). Analyses of covariance were used to examine the main effects and in- teractions of APOE ε4, PTSD, and age on learning/working memory (LWM) and attention/psychomotor (APM) performance.

Results: A significant three‐way interaction between …

Cumulative Risk For Children’S Behavior Problems And Child Abuse Potential Among Mothers Receiving Substance Use Treatment: The Unique Role Of Parenting Stress, Stephanie Gusler, Angela Moreland

Psychiatry Faculty Publications

There is a high prevalence of children whose parents suffer with a substance use disorder (SUD), which is associated with negative outcomes for children such as behavior problems and parents’ child abuse potential. To understand negative consequences for children, it is important to consider a cumulative risk model, examining the impact of multiple co-occurring risks, as well as examine unique singular risk factors, such as parenting stress, which may have a direct effect on outcomes as well as mediate an association between cumulative risk and outcomes. Data came from 99 mothers with SUD, engaged in a substance treatment program. Results …

Cannabidiol And Delta-9-Tetrahydrocannabinol Interactions In Male And Female Rats With Persistent Inflammatory Pain, Stevie C. Britch, Rebecca M. Craft

Behavioral Science Faculty Publications

Cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC), 2 of the primary constituents of cannabis, are used by some individuals to self-treat chronic pain. It is unclear whether the painrelieving effects of CBD alone and in combination with THC are consistent across genders and among types of pain. The present study compared the effects of CBD and THC given alone and in combination in male and female rats with Complete Freund’s adjuvant-induced inflammatory pain. After induction of hindpaw inflammation, vehicle, CBD (0.05−2.5 mg/kg), THC (0.05−2.0 mg/kg), or a CBD: THC combination (3:1, 1:1, or 1:3 dose ratio) was administered i.p. twice daily for …

The Endowment Effect And Temporal Discounting Of Drug And Non-Drug Commodities, Sean D. Regnier, Mark J. Rzeszutek, Justin C. Strickland, Thomas Shellenberg, William W. Stoops

Behavioral Science Faculty Publications

Objectives: Despite a rich history of behavioral economic research on substance use there remains a need for further exploration of behavioral mechanisms that may underlie the etiology or persistence of substance use disorder. The purpose of this study was to measure the association between delay discounting and the endowment effect in people who smoke cigarettes, use cocaine, and controls, using online crowdsourcing. Methods: Participants were categorized to a cocaine group (n = 36), cigarette group (n = 48), or control group (n = 47) based on recent reported drug use. Based on group, participants completed up to three delay discounting …

The Moderating Effect Of Physical Activity On The Relationship Between Bullying And Mental Health Among Sexual And Gender Minority Youth, Sally J. Kirklewski, Ryan J. Watson, Carolyn Lauckner

Behavioral Science Faculty Publications

Background: Sexual and gender minority youth frequently experience bullying, which often contributes to higher depressive symptoms and lower self-esteem. Given that physical activity (PA) can mitigate depressive symptoms and improve self-esteem, we examined the moderating effect of PA on the relationship between bullying and mental health among sexual and gender minority youth.

Methods: Data from the Lesbian, Gay, Bisexual, Transgender, and Queer National Teen Survey (n = 9890) were analyzed. Hierarchical regression analyses examined the influence of history and frequency of being bullied, PA, and the interaction of these variables on depressive symptoms and self-esteem. Simple slopes analyses were used …

Adolescent Intermittent Ethanol Drives Modest Neuroinflammation But Does Not Escalate Drinking In Male Rats, Jessica I. Wooden, Lauren E. Peacoe, Chinchusha Anasooya Shaji, Jennifer K. Melbourne, Cassie M. Chandler, Michael T. Bardo, Kimberly Nixon

Psychology Faculty Publications

During adolescence, the brain is highly susceptible to alcohol-induced damage and subsequent neuroimmune responses, effects which may enhance development of an alcohol use disorder (AUD). Neuroimmune reactions are implicated in adolescent alcohol exposure escalating adulthood drinking. Therefore, we investigated whether intermittent alcohol exposure in male, adolescent rats (AIE) escalated adult drinking via two-bottle choice (2BC). We also examined the influence of housing environment across three groups: standard (group-housed with enrichment during 2BC), impoverished (group-housed without enrichment during 2BC), or isolation (single-housed without bedding or enrichment throughout). In the standard group immediately after AIE/saline and after 2BC, we also examined the …

Prenatal Morphine Exposure Increases Cardiovascular Disease Risk And Programs Neurogenic Hypertension In The Adult Offspring, Nermin Hassan Mohamed Selim Ahmed, Alana Kassis, Jena Malone, Jodie Yang, Esraa Zamzami, An-Hsuan Lin, Scott M. Gordon, Ming C. Gong, Michael T. Bardo, Carolina Dalmasso, Analia S. Loria

Psychology Faculty Publications

BACKGROUND: The opioid overdose and opioid use disorder epidemics are concomitant with increased metabolic and CVD risk. Although opioid use disorder causes adverse pregnancy outcomes, the offspring’s cardiovascular health is understudied. We hypothesized that offspring exposed to in utero morphine exposure (IUME) would show increased CVD risk factors and endogenous opioid system dysregulation.

METHODS: Sprague Dawley dams were treated with saline (vehicle, n=10) or escalating doses of morphine (5–20 mg/kg per day, SC, n=10) during gestation. Cardiovascular and metabolic parameters were assessed in adult offspring.

RESULTS: Litter size and pups’ birth weight were not different in response to IUME. Female …

Effect Of The Glucocorticoid Receptor Antagonist Pt150 On Acquisition And Escalation Of Fentanyl Self-Administration Following Early-Life Stress, Michael T. Bardo, Cassie M. Chandler, Emily D. Denehy, Benjamin A. Carper, Mark A. Prendergast, Tracy L. Nolen

Psychology Faculty Publications

There is comorbidity between posttraumatic stress disorder (PTSD) and opioid use disorder (OUD), perhaps because PTSD-like stressful experiences early in life alter the hypothalamic–pituitary-adrenal stress axis to increase the risk for OUD. The present study determined if the glucocorticoid receptor antagonist PT150 reduces the escalation of fentanyl intake in rats exposed to a “two-hit” model of early-life stress (isolation rearing and acute stress). Male and female rats were raised during adolescence in either isolated or social housing and then were given either a single acute stress (restraint and cold-water swim) or control treatment in young adulthood. Rats were then treated …

Examining Engagement With And Acceptability And Usability Of Real Parenting: A Brief Online Parent-Based Intervention To Reduce Alcohol Use And Consequences Among High School Students, Shannon D. Glenn, Robert Turrisi, Michael L. Hecht, Michael A. Russell, Anne E. Ray

Health, Behavior & Society Faculty Publications

This study is a formative assessment of REAL Parenting (RP): a brief, digital intervention for parents of high school students that encourages parent-teen communication about alcohol and, in turn, aims to prevent teen alcohol use. The aims of this study were to describe engagement with, and acceptability and usability of RP; and to explore the relationship of these measures with each other and with short-term outcomes. Participants were 160 parents randomly assigned to the treatment group who received RP as part of a randomized pilot trial (Mage = 45.43[SD = 7.26], 59.3% female, 56% White, 19% Hispanic). App-based program analytics …

A Mini Review Of What Matters In The Management Of Nas, Is Esc The Best Care?, Enrique Gomez Pomar

Pediatrics Faculty Publications

As the use of opioids and polysubstance by pregnant women has increased over the years, there has also been a sharp increase in cases of neonatal abstinence syndrome (NAS). Classically, infants affected by NAS have been cared for in neonatal intensive care units resulting in an increase of healthcare expenditure and resource utilization as well as separation from the families. Consequently, the Eat, Sleep, and Console (ESC) tool was developed and promoted as a novel method that focuses on maternal/infant dyad during hospital stay while decreasing the use of pharmacological interventions and therefore decreasing the length of stay and healthcare …

Welcome Visitor Or Nosy Neighbor: Executive Branch Presence In Federal And State Judicial Affairs, Audrey Baricovich

Theses and Dissertations--Political Science

Interaction and overlap between branches of government in a separation of powers system is important for maintaining the checks and balances central to democracy. In this dissertation, I examine the effects of executive and judicial branch interaction. This work meaningfully contributes to our understanding of the nature and impacts of executive branch presence in judicial affairs.

In the first chapter, I look at perceptions of presidential influence in Supreme Court justices’ decision-making process. I analyze a national representative survey to examine the conditions under which respondents are willing to credit the president with influence over the decision-making process at the …

Beyond Gatekeeping: Building A Community For Suicide Survivors, Rebecca Thomas

DSW Capstone Projects

Suicide is a complex phenomenon, yet past attempts to change it have relied on an oversimplification that to prevent suicide, suicidal people need professional mental health treatment. Fortunately, that notion has faded. Suicide is now recognized as a public health issue; One that spans various continuums of culture, socioeconomic status, and demographics. With a better understanding and increased recognition of suicide as a public health issue, more stakeholders have engaged in suicide prevention efforts, new research has emerged, and more attention and resources are being dedicated than ever before. This capstone project explores the impact a suicide death has on …

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 …

Characterizing Region Iv State Health Agency - Central Office's Workforce Needs: Results From The 2021 Public Health Workforce Interest And Needs Survey (Ph Wins), Ashley Carroll

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

The purpose of this project was to examine the Region IV State Health Agency – Central Office workforce in regards to retention and reasons for leaving; workforce satisfaction levels and how that influences retention; and training gaps among non-supervisors. An extensive review of existing literature was completed and showed that since the great recession, there has been a loss of 40,000 positions at state and local governmental health agencies (Castrucci & Lupi, 2020). In addition, from 2008 to 2019, there has been a 16 percent decline in the national public health workforce, and 47 percent of public health workers plan …

A Case Study In Program Evaluation: Evaluation Of A Hypertension Self Management Program, Bailey N. Schenk

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

The CDC's program evaluation process framework is a six-step approach that guides public health practitioners in the evaluation of public health programs. The framework includes engaging stakeholders, describing the program, focusing the evaluation design, gathering credible evidence, justifying conclusions, and ensuring use and sharing of lessons learned. Each step is important in developing a comprehensive and effective program evaluation. This evaluation discusses the application of the six steps of the CDC's program evaluation process framework and how it was utilized in evaluating a hypertension self-management program at a local health department.

Changes In Severity Of Diabetes At Diagnosis Following The Onset Of The Sars-Cov-2 Pandemic, Annelise King

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

During the SARS-CoV-2 pandemic it was seen that diabetes was a risk factor for severe COVID-19. The objective of this study is to assess the severity of diabetes at diagnosis during the COVID-19 pandemic compared to pre-pandemic to see how the pandemic and SARS-CoV-2 infection impacted the severity of diabetes. This study used University of Kentucky electronic health records of 13,794 patients who developed diabetes. The majority of patients were female, white non-Hispanic, 65+, and living in an urban area. There were differences seen between the COVID-19 positive and negative cohorts in the DKA and HbA₁c variables, with …

Effect Of Medicaid Expansion On Inflammatory Bowel Disease And Healthcare Utilization, Brittany Levy

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

Inflammatory bowel disease (IBD) affects over 3 million adults in America, relaying a

need for chronic disease management. Along with 24 other states, Kentucky expanded the

Medicaid program January 1, 2014. We hypothesize, Medicaid expansion adoption results in

reduced emergency healthcare services, and increased elective healthcare services with a

reduction in overall healthcare utilization by individuals in the adult IBD population.

The Hospital Inpatient Discharge and Outpatient Services Database identify encounters

related to ulcerative colitis or Crohn’s disease from 2009-2020, in Kentucky. Patient

demographics, admission type, discharge, length of stay, and hospital charges were compared.

3386 pre-expansion and 24255 post …

Health Management And Policy Capstone: A Case Study In Program Evaluation, Kelsey R. Gatton

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

Program evaluation of a hypothetical comprehensive hypertension self-management program as directed by the CDC Framework for Program Evaluation in Public Health.