Digital Commons Network^™

Methenamine Prophylaxis For Recurrent Urinary Tract Infections In A Tertiary Referral Center, Cameron A. Wade

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

Purpose: Methenamine hippurate (MH) is a urinary antiseptic, indicated for prophylaxis of recurrent urinary tract infections (UTIs) but with only few and limited studies regarding its efficacy. To help address this knowledge gap we reviewed our experience with MH for UTI prophylaxis, focusing on women with recurrent uncomplicated UTIs.

Materials and Methods: The University of Kentucky electronic health record was queried to identify adults who were prescribed MH from the Urology clinic between January 2013 and January 2019. Charts were reviewed to assess patient-reported UTI frequency, demographics and relevant health factors. Treatment success was defined as 0-1 UTI in 6 …

Injuries Among Distillery Workers: Workers' Compensation First Reports Of Injury, 2010-2019, Mira Hali Mirzaian

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

AIMS: To identify the most frequent type, nature, and cause of work-related injury amongst distillery workers as well as contributing factors to the injurious event in an effort to inform potential intervention.

METHODS: Workers’ Compensation First Reports of Injury (FROI) from the years 2010-2019 (N=974) were obtained. Variables were created for ‘occupational category’ and ‘accident description’ to assist in the elucidation of the injurious event. The Ratchet Circular Scan Test was used to assess seasonal variation in injury. Kernal Density Analysis was conducted to assess rates of injury by calendar year.

RESULTS: Amongst injured distillery workers, 908 of the injuries …

Healthy Living People: A Hiv Transmission Intervention In Four Chicago Communities, Angela Wuerger

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

The transmission of HIV within the city of Chicago has been established as a major health concern: however, the lack of adequate resources has created gaps within current programming available for people living with HIV. Healthy Living People (HLP) is an evidence-based program focused on reducing the transmission of HIV through strengthening adherence to antiretroviral therapy and decreasing number of higher risk sexual encounters. The Chicago Department of Public Health will provide the HLP program, which includes fifteen 90-minute sessions over the course of one year. The HLP program will be offered for people living with

HIV in four Chicago …

Can Treatment Of Social Isolation And Loneliness Reduce Healthcare Utility? An Analysis Of Social Prescribing, Matthew Mattingly

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

The paper focuses on the practice of social prescribing as it is currently implemented through the National Health Service (NHS) of the United Kingdom. Social Prescribing is an emerging healthcare intervention aimed at referring patients to community-based activities. NHS promotes social prescribing as a method of reducing healthcare utilization in chronically ill patients. Current evidence on social prescribing is subject to significant variation and has not supported NHS’s claims. The potential link between feeling of social isolation, loneliness and chronic illness was further investigated through data from the National Social Life, Health & Aging Project (NSHAP). Data was tested for …

Rabies In Kentucky From 1989-2020: A Case For Surveillance, Sarah Jane Robbins

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

The Kentucky rabies reporting system includes data from five laboratories and provides an account of suspected rabies reports since 1989. Over 35,000 suspected cases are used to estimate rabies incidence temporally and spatially. Recommendations to the current rabies reporting methodologies are presented through proposed innovations of a standard, electronic reporting form. Given the multiple sources of data, the reporting system lacks standardization and comprehensive information about suspected rabies events, resulting in limited epidemiological capabilities; and data issues that prevent its use as a surveillance system. These issues are a limiting factor in rabies elimination; but a driving factor in over-testing, …

Implementation Of A School-Based Sexual Health Curriculum For Fayette County, Kentucky Public Schools, Laura P.H. Bellnier

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

Adolescents in the United States are vulnerable to negative sexual health outcomes such as unplanned pregnancy and sexually transmitted infections (STIs) due to a high prevalence of risky sexual behaviors in this population. Research demonstrates that providing adolescents with comprehensive sexuality education that addresses sexual health knowledge, attitudes, and behaviors can increase protective behaviors, such as condom use and decrease negative health outcomes over the long term. Implementing a comprehensive sexuality education program in a public school setting is an effective strategy to reach a large number of adolescents and targeting early adolescents can influence student sexual health knowledge, attitudes, …

Volatile Organic Compound Exposure And Hearing Loss In Children, Brooke Spillman

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

Hearing loss is often associated with repeated exposure to noise levels above 85 decibels. While noise is noted as the largest contributor to hearing loss, some fail to consider the impacts of chemical exposure on the hearing health of children, specifically VOCs. Early detection and prevention of hearing loss in children is important due to the impacts that hearing has on the learning, behavior, speech, and language development of children. This study examined the relationship between VOC exposure and hearing loss in children using NHANES data collected from 2005-2006. This was analyzed with Chi-square analyses and a logistic regression taking …

Maternal Residential Proximity To Surface Mining Associated With Preterm Birth And Low Birth Weight In Appalachian Kentucky, Whitney Smith

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

Objective: This study aims to examine the relationship between maternal residency in a county with surface coal production and preterm birth or low birth weight.

Methods: A cross-sectional study was conducted using birth records (n=62,766) for 54 Appalachian counties and coal production in tons. Logistic regression and chi-squared analysis was done to analyze the relationship between surface coal mining and preterm birth and low birth weight in two different birth groups.

Results: After controlling for covariates, statistically significant increases were seen in Birth Group 1 and Birth group 2. Birth Group 1 had statistically significant results for preterm birth ((1.19 …

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. …

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 …

Healthy, Fit, & Strong: A Parent-Child Physical Activity Program For Families With Obese And Overweight Adolescents, Patrick Maloney

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

Over 20% of Kentucky children between the ages of 10-17 are obese, the third highest prevalence in the nation. The Healthy, Fit, & Strong Program works with children with a BMI above the 85th percentile and their parents to improve behaviors related to physical activity (PA) and nutrition. The intervention is a 12-week program which features tri-weekly physical activity sessions and nutrition classes. Both children and parents participate in activities in order to build knowledge and confidence related to healthy behaviors. The goal of this intervention is to improve upon baseline physical activity levels and diet as well as to …

Alcohol Excise Taxes And Their Effects On The Community, Christopher R. Watts

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

Objectives: This study examines the association of an additional excise tax on alcoholic beverages in Georgetown, Kentucky with alcohol-related motor vehicle accidents. Evaluate the additional benefits of the excise tax on the community of Georgetown, Kentucky.

Methods: Using an interrupted time series design, this study compares alcohol-related crash statistics from two similar cities based on 126 months of data from the Kentucky State Police. Analyses included linear regression and Poisson models to evaluate the data in each city to determine population-wide results.

Results: Alcohol-related motor vehicle crashes immediately declined (-12.5%) in Georgetown following the implementation of the excise tax and …

Mitigating Opioid Related Healthcare Use In Kentucky: An Assessment Of The Impact Of Kentucky Revised Statute (Krs) Changes To Opioid Prescribing On Opioid Related Prescribing And Healthcare Utilization, Drew Speer

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

The opioid epidemic has impacted few other places more than the state of Kentucky. In 2018, data from the Centers of Disease Control and Prevention (CDC) and the National Institute on Drug Abuse (NIDA) ranked Kentucky as being in the top ten for rate of drug overdose deaths and opioid-involved overdose deaths per 100,000 persons.^1,2 These rankings exist even though prescription opioid dispensing rates have fallen from 102.6 per 100 persons in 2015 to 72.3 per 100 persons in 2019.³ Aligning with this trend, while research shows this problem began with prescription opioids in the late 1990’s, it …

Risk Factors Of Carbapenem-Resistant Enterobacteriaceae Acquisition Among Adult Intensive Care Unit Patients At A Kentucky Academic Medical Center, Jason Eric Wilson, Jason Wilson

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

Background: This study aimed to identify risk factors of carbapenem-resistant Enterobacteriaceae (CRE) acquisition among adult intensive care unit (ICU) patients at a Kentucky academic medical center and to evaluate sink drains as a possible environmental reservoir of carbapenem-resistant organism (CRO) transmission.

Methods: A retrospective cohort study was conducted from October 1, 2013 through October 31, 2016. Intensive care unit patients were screened for CRE at admission and weekly until discharge. Cases were defined as patients who tested positive for CRE on ICU admission day 3 or greater. Sink drains were sampled for CROs in selected units from January 2018 through …

Assessment Of The University Of Kentucky's Nutrition Education Program's Smarter Lunchrooms Pilot Plate Waste Project In Three Kentucky Schools, Natalie Jones

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

School-based approaches utilizing policy, systems, and environmental strategies are needed to address the complex factors driving childhood obesity. The purpose of this pilot study is to implement Smarter Lunchroom strategies in three participating Kentucky middle schools in 2019 and then assess two outcomes: (1) determine the impact of the intervention on fruit and vegetable purchases and waste, and (2) determine how purchases or waste varied by interventions selected for each setting. After the 6-week intervention, combined we found no statistical significant increases in fruit and vegetable purchasing from pre to post-intervention. No statistical significant decreases in fruit and vegetable plate …

An Evaluation Of Injurious Falls And Fall-Risk-Increasing-Drug (Frid) Prescribing Behaviors In A Nationally Representative Sample & The Pharmacist’S Role In Fall Prevention, Taylor Elliott, Susan Westneat, Shama Karanth, Erin Abner, Anna Kucharska-Newton, Daniela C. Moga

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

Background: Falls are a major public health problem affecting millions of older adults each year. Little is known about FRID prescribing behaviors after injurious falls occur.

Objective(s): The primary objective of this study was to investigate whether an injurious fall impacts the odds of being prescribed a new FRID.

Methods: We conducted a cross-sectional analysis using data from the 2016 National Ambulatory Medical Care Survey to investigate whether an injurious fall impacts the odds of being prescribed a new FRID. We included patients age >/= 65 years and classified visits based on presence of an injurious fall. The outcome of …

A Case Study To Explore The Perception Of A Woman Participant In Drug Court Of A Community-Based Arts Program On Substance Use Recovery Outcomes, Catherine L. Troop

Theses and Dissertations--Early Childhood, Special Education, and Counselor Education

Addiction to drugs is a complex, chronic, and multi-faceted disease that often involves cycles of relapse and remission. The lifetime prevalence of alcohol and drug use disorders in women in the United States is 19.5 percent and 7.1 percent, respectively (McHugh, Wigderson, & Greenfield, 2014) yet there is a significant dearth of efficacious substance abuse treatment services tailored specifically to women. In addition, literature suggests that the third aspect of Bandura’s Social Cognitive theory (self-efficacy) potentially plays a significant role in abstinence of drug use. The role of art interventions on recovery outcomes for a woman enrolled in the Franklin …

Coaching Caregivers In Rural Communities On Naturalistic Strategies Via Telehealth, Stevie L. Ogburn

Theses and Dissertations--Early Childhood, Special Education, and Counselor Education

Naturalistic strategies have been shown in research to promote expressive language in children by embedding opportunities for learning trials during routines and activities. Efforts to promote expressive language development are often focused on training caregivers in implementing naturalistic strategies in their child’s typical daily routine. Coaching is a consistently effective training practice to prepare family members to implement the naturalistic strategies. While coaching has been shown to be effective, the recommended time requirement could be a barrier for most caregivers. Caregivers living in geographically remote areas also face additional barriers, such as higher rates of poverty and less access to …

Comparative Effects Of Words Plus Pictures And Words Alone On The Reading Comprehension Of Youth With Disabilities, Lindsay Caudill

Theses and Dissertations--Early Childhood, Special Education, and Counselor Education

This study compared the effectiveness and efficiency of two instructional conditions on the reading comprehension of fifth and sixth grade students with moderate and severe disabilities. A words plus pictures and words alone condition were examined through the use of an adapted alternating treatment design replicated across 3 participants. Results indicated that the effect was minimal, with words plus pictures being slightly more effective.

The Effects Of Using Constant Time Delay To Teach Digraphs To Elementary Students With Mild Disabilities, Sara Schuer

Theses and Dissertations--Early Childhood, Special Education, and Counselor Education

Constant time delay (CTD) is a near-errorless response prompting procedure that involves a presentation of a stimulus, a delay interval, and a controlling prompt. The purpose of this study was to determine the effectiveness of teaching vowel/consonant digraph sounds to children with mild disabilities using constant time delay. A multiple probe (conditions) across behaviors design, replicated with three students, was used. The results indicated that CTD is effective in teaching vowel/consonant digraphs to elementary students with mild disabilities which then generalize to reading words containing those same digraphs.

The Relationship Between Stress And Quality Of Life In People With Multiple Sclerosis: The Mediating Role Of Resilience, Byung Jin Kim

Theses and Dissertations--Early Childhood, Special Education, and Counselor Education

Multiple sclerosis (MS) is a chronic disease of the central nervous system encompassing the brain, spinal cord, and optic nerve, in which the patient’s immune system attacks healthy cells and tissues. Due to the unpredictable characteristics of the disease, MS can lead to an unusually high level of stress and may negatively impact the individual’s QoL. Resilience is a psychological structure that shows positive coping and adaptive ability from difficult or stressful situations. Resilience also indicates a buffering effect on the stressors of individuals with disabilities and serves to protect psychological health and function from disability. The purpose of this …

Factors Influencing Mare Milk And Foal Gastrointestinal Health, Morgan Brewer Pyles

Theses and Dissertations--Animal and Food Sciences

Foals are born lacking a functional microbial community in their gastrointestinal tract (GIT). However, these microbes quickly colonize after birth. Factors influencing the process of microbial colonization and health of the foal’s gastrointestinal tract, such as milk yield and composition, are not well understood. Milk contains non-lactose carbohydrates termed “oligosaccharides”, which serve as prebiotics in human neonates and may serve a similar function in foals. Three animal studies were conducted to evaluate factors influencing mare milk and digestive health in the foal. In experiment 1, bacteria were enumerated and identified in foal feces and the utilization of different carbohydrates by …

The Effect Of Endophyte-Infected Tall Fescue Seed Consumption On Gut And Satiety Hormones Related To Intake Regulation In Holstein Steers, Mindy Elizabeth King

Theses and Dissertations--Animal and Food Sciences

Cattle consuming endophyte-infected tall fescue (E+) typically experience a syndrome termed fescue toxicosis which is thought to be caused by ergot alkaloids produced by the endophyte. The most abundant alkaloid, and considered the most likely cause of the syndrome, is ergovaline (ERV). During fescue toxicosis, a decrease in ADG is observed which is likely due to the decrease in DMI commonly observed in animals consuming E+ compared to animals consuming non-endophyte-infected tall fescue (E-). However, the cause of the decrease in intake is not well elucidated. Many physiological responses control feed intake including, but not limited to, physical, neural, metabolic, …

Isolation Box Test (Ibt) And Dairy Calf Personality Traits Relationship With Performance Through Weaning, Megan Marie Woodrum Setser

Theses and Dissertations--Animal and Food Sciences

Personality tests are utilized to characterize individual differences in personality traits across species. Currently, there is no objective personality test that can be implemented on-farm to measure personality in dairy calves. Measuring personality of youngstock in the dairy industry may allow producers to utilize information on individual differences for management decisions and limit the investment in unfit individuals. The isolation box test is a personality test that has potential to be adapted and utilized for dairy calves. The main objective of this thesis is to develop, validate, and utilize an isolation box test for use on-farm in dairy calves. More …

New Evidence For P-Gp-Mediated Export Of Amyloid-Β Peptides In Molecular, Blood-Brain Barrier And Neuronal Models, Amanda B. Chai, Anika M. S. Hartz, Xuexin Gao, Alryel Yang, Richard Callaghan, Ingrid C. Gelissen

Sanders-Brown Center on Aging Faculty Publications

Defective clearance mechanisms lead to the accumulation of amyloid-beta (Aβ) peptides in the Alzheimer’s brain. Though predominantly generated in neurons, little is known about how these hydrophobic, aggregation-prone, and tightly membrane-associated peptides exit into the extracellular space where they deposit and propagate neurotoxicity. The ability for P-glycoprotein (P-gp), an ATP-binding cassette (ABC) transporter, to export Aβ across the blood-brain barrier (BBB) has previously been reported. However, controversies surrounding the P-gp–Aβ interaction persist. Here, molecular data affirm that both Aβ₄₀ and Aβ₄₂ peptide isoforms directly interact with and are substrates of P-gp. This was reinforced ex vivo by the …

Corporate Misconduct In The Pharmaceutical Industry, Richard C. Ausness

Law Faculty Scholarly Articles

Sadly, many pharmaceutical companies have engaged in unethical or illegal behavior. The current opioid crisis is the most recent example of misconduct by pharmaceutical companies. Moreover, this pattern of conduct is neither rare, nor recent. Instead, it is long-standing and pervasive in nature. Furthermore, unlike wrongdoing by other businesses that cause primarily economic or environmental harm, wrongdoing by pharmaceutical companies, like that of asbestos or tobacco companies, may cause personal injuries and death on a large scale.

Undue Deference To States In The 2020 Election Litigation, Joshua A. Douglas

Law Faculty Scholarly Articles

COVID-19 has wreaked havoc on so much of our lives, including how to run our elections. Yet the federal courts have refused to respond appropriately to the dilemma that many voters faced when trying to participate in the 2020 election. Instead, the courts—particularly the U.S. Supreme Court and the federal appellate courts—invoked a narrow test that unduly defers to state election administration and fails to protect adequately the fundamental right to vote.

Grounding Suicide Terrorism In Death Anxiety And Consumer Capitalism, James M. Donovan

Law Faculty Scholarly Articles

This article examines an influential theory on suicide attacker motivations, the Significance Quest Theory, and suggests that this death anxiety approach can be improved by shifting its focus toward the related, but more comprehensive, Terror Management Theory. The theoretical productivity of this realignment is tested by examining the relationship between suicide attacks and one of the variables thought to trigger the underlying anxieties: the local pressures from global consumer capitalism. After describing the relationship between death anxiety and suicide terrorism generally, this article concludes by applying these insights to the ethnographic context of Egypt.

Keeping It In The Family: The Pitfalls Of Naming A Family Member As A Trustee, Richard C. Ausness

Law Faculty Scholarly Articles

This article is concerned with trusts in which either the settlor, trustee, or beneficiaries are members of the same family. For example, the settlors may be the parents, grandparents, or other relatives of the trust beneficiaries. Trustees may be settlors, parents of the beneficiaries, children of the settlor, and other family members, while beneficiaries may include either the settlor, the settlor's spouse, children, grandchildren, or other relatives of the settlor. These persons will be referred to as "family members."

Virtually all family members have disagreements with other family members and sometimes these disagreements can destroy relationships and even lead to …

Causation And Apportionment Issues In Opioid Litigation, Richard C. Ausness

Law Faculty Scholarly Articles

In November 2019, an Oklahoma trial court judge, sitting without a jury, ruled that Johnson & Johnson and its subsidiary Janssen Pharmaceuticals were guilty of creating a public nuisance because their production and marketing of prescription opioid painkillers significantly contributed to the current opioid epidemic in the State of Oklahoma. The judge also held that Johnson & Johnson must contribute $65 million to pay for the State's program to abate this nuisance. Although the case has been appealed, it is significant because it was the first government sponsored opioid case to actually go to trial. Although there are many issues …