Frequency And Types Of Healthcare Encounters In The Week Preceding A Sepsis Hospitalization: A Systematic Review, Alexander H. Flannery, Chad M. Venn, Amanda Gusovsky, Stephanie Henderson, Adam S. Kiser, Hallie C. Prescott, Chanu Rhee, Chris Delcher, Peter E. Morris

Pharmacy Practice and Science Faculty Publications

OBJECTIVES: Early recognition and treatment are critical to improving sepsis outcomes. We sought to identify the frequency and types of encounters that patients have with the healthcare system in the week prior to a sepsis hospitalization.

DATA SOURCES: PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, and the Cochrane Library.

STUDY SELECTION: Observational cohort studies of patients hospitalized with sepsis or septic shock that were assessed for an outpatient or emergency department encounter with the healthcare system in the week prior to hospital admission.

DATA EXTRACTION: The primary outcome was the proportion of patients with a healthcare encounter …

A Global Survey Of Infection Control And Mitigation Measures For Combating The Transmission Of Covid-19 Pandemic In Buildings Under Facilities Management Services, Hadi Sarvari, Zhen Chen, Daniel W. M. Chan, Ellyn A. Lester, Nordin Yahaya, Hala Nassereddine, Aynaz Lotfata

Civil Engineering Faculty Publications

Facilities management along with health care are two important aspects in controlling the spread of infectious diseases with regard to controlling the outbreak of global COVID-19 pandemic. Hence, with the increasing outbreak of COVID-19 pandemic, the importance of examining the relationship between the built environment and the outbreak of infectious diseases has become more significant. The aim of the research described in this article is to develop effective infection control and mitigation measures to prevent the transmission of COVID-19 pandemic in the built environment. This study seeks to answer the question of how the facilities management industry can help reduce …

A Global Survey Of Infection Control And Mitigation Measures For Combating The Transmission Of Covid-19 Pandemic In Buildings Under Facilities Management Services, Hadi Savari, Zhen Chen, Daniel W. M. Chan, Ellyn A. Lester, Nordin Bin Yahaya, Hala Nassereddine, Aynaz Lotfata

Civil Engineering Faculty Publications

Facilities management along with health care are two important aspects in controlling the spread of infectious diseases with regard to controlling the outbreak of global COVID-19 pandemic. Hence, with the increasing outbreak of COVID-19 pandemic, the importance of examining the relationship between the built environment and the outbreak of infectious diseases has become more significant. The aim of the research described in this article is to develop effective infection control and mitigation measures to prevent the transmission of COVID-19 pandemic in the built environment. This study seeks to answer the question of how the facilities management industry can help reduce …

Associations Between Feeding Behaviors Collected From An Automated Milk Feeder And Neonatal Calf Diarrhea In Group Housed Dairy Calves: A Case-Control Study, Meridith H. Conboy, Charlotte B. Winder, Melissa C. Cantor, Joao H. C. Costa, Michael A. Steele, Catalina Medrano-Galarza, Taika E. Von Konigslow, Amanda Kerr, Dave L. Renaud

Animal and Food Sciences Faculty Publications

The objective of this case-control study was to determine if feeding behavior data collected from an automated milk feeder (AMF) could be used to predict neonatal calf diarrhea (NCD) in the days surrounding diagnosis in pre-weaned group housed dairy calves. Data were collected from two research farms in Ontario between 2017 and 2020 where calves fed using an AMF were health scored daily and feeding behavior data (milk intake (mL/d), drinking speed (mL/min), number of rewarded or unrewarded visits) was collected. Calves with NCD were pair matched to healthy controls (31 pairs) by farm, gender, and age at case diagnosis …

Motivating The Protection Of Others: A Theoretical Extension And Empirical Test Of Compassion Appeals, Erin B. Hester

Theses and Dissertations--Communication

The term “wicked problems” is used to describe a constellation of social issues that are deeply entangled (Rittel & Webber, 1973). Although these social messes affect everyone in society, some people suffer more than others (Ackoff, 1974). Nevertheless, tackling wicked problems begins with recognizing our shared responsibility to ease the misfortune of others (Rittel & Webber, 1973). As such, they provide an ideal context to investigate the persuasive effectiveness of messages that encourage the protection of others (i.e., other-protection messages). Wicked problems, such as the opioid crisis and food insecurity, need strategies that compel individuals to engage in prosocial action …

Local Public Health System Comprehensiveness And Opioid Overdose Mortality, 2012-2018, Stephanie Courtney

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

Background: Deaths due to opioid overdose are a significant public health burden in the United States. Studies suggest that local public health systems that perform a high number of essential activities where local health departments contribute to the delivery of the activities and promote increased partnership may positively influence population health outcomes such as overdose mortality. Studies have shown that comprehensive public health systems are associated with improved health outcomes, but this association has not been addressed in the context of opioid overdose deaths. Study Aim: The purpose of this study is to evaluate the associations between local public health …

Neurophysiological And Psychological Characteristics Of Individuals With History Of Lateral Ankle Sprain, Katherine Bain

Theses and Dissertations--Rehabilitation Sciences

Lateral ankle sprain (LAS) is among the most common lower limb musculoskeletal injuries impacting both the general and sport populations. Even more problematic is that approximately 70% of individuals who sustain an LAS develop residual deficits. Of that subgroup, roughly 40% develop chronic ankle instability (CAI). Chronic ankle instability is a clinical diagnosis defined by the presence of ongoing impairments following the initial LAS which may include perceived instability, pain, mechanical instability, and episodes of giving way during physical activity. Not all who sustain multiple ankle sprains or experience residual deficits fit the clinical diagnosis criteria for CAI; yet may …

Identifying Factors Associated With Syringe Reuse Among People Who Inject Drugs (Pwid) In Appalachia Kentucky, Grayson Keith Fuller

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

Aim: Syringe reuse contributes to the spread of infectious diseases. The purpose of this study is to identify factors associated with syringe reuse among people who inject drugs (PWID) in Kentucky.

Methods: PWID (n=238) completed interviewer-administered questionnaires to collect data on syringe reuse and demographic, behavioral, and clinical characteristics. Negative log binomial regression was used to model the associations.

Results: On average, people reused each syringe 9.3 times (median: 3; IQR: 2-10, range 1-95). Syringe reuse was higher among men [aOR=1.386; 95% CI: 1.041-1.845] and those who injected methamphetamine [aOR=2.122; 95% CI: 1.445-3.116]. Reuse was also higher among those who …

Covid-19 Mitigation Strategies School Staff In Indiana, Kentucky, And Ohio, Luu Le

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

Abstract

Background: This cross-sectional study aims to identify the difference in COVID-19 mitigation strategies implementation and adherence among elementary, middle, and high schools in Indiana, Ohio, and Kentucky, based on data from the School Staff Health and Wellness Study research at the University of Kentucky in 2020.

Methods: The sample size of the study was 6,794 participants who work at elementary, middle, or high schools in Indiana, Ohio, and Kentucky. Complete case analyses were performed, which included observation with no missingness in variables (N = 5,971). Descriptive statistics were generated, including a table indicating the implementation of COVID-19 mitigation strategies …

Comparing Governmental Communication About Covid-19 Layered Protection Strategies In Taiwan, Kenya, And The United States: A Mixed-Method Analysis Of National Health Agency Websites, Cynthia Mofunanya

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

COVID-19 is a novel coronavirus caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It can result in severe respiratory damage. Different countries have recommended different combinations of protections during the COVID-19 pandemic. Various combinations of mitigation strategies or “layered protections” against coronavirus have also been communicated differently across nations. This mixed-methods content analysis seeks to compare COVID-19 mitigation information on three national health agency websites for Taiwan, Kenya, and the United States. Availability and navigability of information was examined for each mitigation strategy. The Web Resource Rating tool was used to assess the quality of the information about …

Covid-19, Chronic Stress, And Adolescent Mental Health, Corina Barker

DSW Capstone Projects

The COVID-19 pandemic has had an undeniable impact on adolescent mental health. Though not considered to be high risk when it comes to physically contracting the virus itself, adolescents have shown to be significantly impacted by the indirect effects of the pandemic. Because of the unique and formative time, this is in their lives, adolescents are already vulnerable to the impact of social stressors. Risk factors associated with the COVID-19 pandemic such as social isolation, disruption in routine, uncertainty, fear, and chronic stress have all proven to have a profound negative impact on adolescent mental health and overall well-being. It …

Use Of Image Processing Techniques And Machine Learning For Better Understanding Of T Gondii Biology, Amer Asiri

Theses and Dissertations--Biomedical Engineering

Almost one in every three people worldwide is infected with Toxoplasma gondii (T. gondii). The biology and growth of the parasite’s bradyzoite form in host tissue cysts are not well understood. T. gondii’s metabolic state influences the morphology of its single mitochondrion, which can be visualized using fluorescence microscopy with specific dyes. Hence, fluorescence microscopy images of cysts purified from infected mouse brains carry biological information about bradyzoites, the poorly understood form of the parasite within them. With the help of fluorescence microscopy techniques, previous studies extracted images of the mitochondrion, nucleus, and the inner membrane complex (IMC) …

Colonial Contraception: American Birth Control Advocates And Their Work In Appalachia, Puerto Rico, And India; 1930-1970, Dana Johnson

Theses and Dissertations--History

By the beginning of the twentieth century, the development of better contraceptives and changing cultural attitudes led to an increased interest in contraceptive research. Although major political, legal, social, religious, and cultural obstacles remained, birth control advocates began to perform clinical trials to identify effective contraceptives and to disseminate contraceptive information. These trials began in the United States, but birth control advocates quickly introduced them into other areas. In this dissertation, I examine the research efforts of the American birth control movement through an analysis of the activities and discourse of its key advocates and promoters during the middle decades …

Response Of Dopaminergic System To Cocaine Exposure, Recovery After Cocaine Abstinence, And Impact Of A Long-Acting Cocaine Hydrolase, Jing Deng

Theses and Dissertations--Pharmacy

Cocaine produces its physiological effects by targeting multiple proteins in the central nervous system, particularly by binding with dopamine transporter (DAT) to block the normal dopamine (DA) recycling process. This process along with the pleasure feeling would wear off shortly after the abstinence from the drug. However, chronic cocaine use is associated with neuroadaptations in the dopaminergic system, including increases in the density of DAT on plasma membrane of dopaminergic neurons. Given the critical role of DAT in neurotransmission, various studies have been carried out on animal models to learn its structure, function, and distribution. Long-standing evidence supports that DAT …

Addressing Ascertainment Bias In The Study Of Cardiovascular Disease Burden In Opioid Use Disorders - Application Of Natural Language Processing Of Electronic Health Records, Jade Huang Singleton

Theses and Dissertations--Epidemiology and Biostatistics

In the United States, the prevalence of long-term exposure to opioid drugs, for both medically and nonmedically indicated purposes, has increased considerably since the mid-1990’s. Concerns have emerged about the potential health effects of opioid use. There is also growing interest in other possible connections with opioid use including cardiovascular disease. Electronic health records (EHR) contain information about patient care in the form of structured codes and unstructured notes. Natural language processing (NLP) provides a tool for processing unstructured textual data in EHR clinical notes and extracts useful information for research with structured formats. The purpose of this dissertation was …

Opioid Use Disorder Treatment With Buprenorphine: Analysis Of Treatment Utilization And Associated Outcomes In Kentucky, Feitong Lei

Theses and Dissertations--Epidemiology and Biostatistics

Opioid use disorder (OUD) is chronic opioid use that results in clinically significant suffering, impairment, or even death. The opioid epidemic in the United States has become a public health and economic crisis, affecting patients' well-being and the nation's overall health and welfare. Eastern Kentucky was among the first regions affected by the opioid crisis, and Kentucky has historically ranked among the top five states for age-adjusted drug overdose mortality rate.

There are three medications (buprenorphine, methadone, naltrexone) approved by the U.S. Food and Drug Administration to treat OUD. As a partial opioid agonist, buprenorphine is a safe medication for …

Nutritional Status In Critical Care Of Covid-19 Patients, Dolph Lewis Davis Iii

Theses and Dissertations--Nutrition and Food Systems

Critical care nutrition is a poorly researched, and such a sudden pandemic event requiring manipulation of nutritional status via propofol-induced sedation for mechanical ventilation is potentially impactful on patient outcomes. This paper seeks to provide context to the impact of critical care protocols on the nutritional status of obese patients suffering from COVID-19.

Dissecting The Role Of Actin-Myosin Motor And Calcium – Based Organelle Secretion In Motility Of Sarcocystis Neurona, Parul Suri

Theses and Dissertations--Veterinary Science

Sarcocystis neurona is a protozoan parasite that causes a rare neurological disorder in horses called Equine Protozoal Myeloencephalitis (EPM). Apicomplexa use actin-myosin based motor and organelle secretion to interact with the host cell and invade it. Despite the importance of motility and invasion-needed factors, the mechanisms by which S. neurona employs host cell association strategies to interact remains largely undefined. To address this knowledge gap, we hypothesize that just like other Apicomplexa, S. neurona utilizes actin polymerization for substrate-dependent gliding. Moreover, we also hypothesize that micronemes of S. neurona secrete proteins that are calcium-dependent. Based on previous studies in T. …

The Microbiome Of The Equine Roundworm, Parascaris Spp., Jennifer Lynn Cain

Theses and Dissertations--Veterinary Science

Parasitic nematodes, including the large roundworms colloquially known as ascarids, affect the health and well-being of livestock animals worldwide. The equine ascarid, Parascaris spp., was the first ascarid parasite to develop wide-spread anthelmintic drug resistance, with other species slowly following suit. There are no new classes of anthelmintics currently in development, and a solution to the ever-increasing prevalence of resistance is desperately needed. The microbiome has been shown to be an important factor in the fitness and health of many organisms and changes to microbiome composition have been associated with a plethora of diseases. The microbiome is also important to …

Bat Activity On West Virginia Mined Lands Restored Via The Forestry Reclamation Approach, Briana C. Snyder

Theses and Dissertations--Forestry and Natural Resources

The Forestry Reclamation Approach (FRA) is a practical guide to reforesting surface mined lands. Bats, as a unique group of species with declining populations, could benefit from this reforestation. In order to determine if the FRA is providing suitable bat foraging habitat, I surveyed bat activity at created depressional wetlands on 1-year old and 8-year old FRA restored lands (FRA1; FRA8), as well as at naturally formed wetlands in regenerating forest on traditionally reclaimed mined land (~40 years old; REGEN) and wetlands in mature forest not previously mined (MAT). I passively recorded echolocation calls for 12 nights across sixteen sites …

Effects Of Snake Fungal Disease On The Survival And Growth Of The Queensnake (Regina Septemvittata), Andrew Jerome Ibach

Theses and Dissertations--Forestry and Natural Resources

Having only emerged as a threat to snakes in 2006, relatively little is known of snake fungal disease’s (SFD) impacts on demographic processes, particularly survival and growth. I used data from an extensive capture-mark-recapture study to examine survival and growth in central Kentucky Queensnake (Regina septemivittata) populations. I found that diseased snakes and healthy snakes possessed similar monthly survival estimates (SFD positive 0.9687, 95% CI 0.8444 to 0.9944; SFD negative 0.8735, 95% CI 0.7518 to 0.9402) and that disease state transition probability from SFD negative to SFD positive, and SFD positive to SFD negative were also similar (N-P …

An Examination Of Three Transitional Events In The Substance Misuse Trajectories Of Women With Criminal Legal System Involvement, Martha Tillson

Theses and Dissertations--Sociology

Research has consistently demonstrated that criminal legal system (CLS)-involved women are distinct from men in initiation and course of drug use, with important differences on biological, environmental, and sociocultural levels. Thus, the unique pathways and transitions into and out of drug use for women with CLS involvement are critical to consider from a research perspective, but also from a need to develop and support evidence-based, women-centered services in correctional contexts. This dissertation project uses a three-paper format to investigate three aims: (1) to understand CLS-involved women’s initiations to injection drug use and their experiences providing injection initiation assistance (IIA) to …

An Integrated Computational Pipeline To Construct Patient-Specific Cancer Models, Daniel Plaugher

Theses and Dissertations--Mathematics

Precision oncology largely involves tumor genomics to guide therapy protocols. Yet, it is well known that many commonly mutated genes cannot be easily targeted. Even when genes can be targeted, resistance to therapy is quite common. A rising field with promising results is that of mathematical biology, where in silico models are often used for the discovery of general principles and novel hypotheses that can guide the development of new treatments. A major goal is that eventually in silico models will accurately predict clinically relevant endpoints and find optimal control interventions to stop (or reverse) disease progression. Thus, it is …

Increasing Staff Compliance With Routine Hcv Screening And Improving Linkage To Care Among Patients Testing Hepatitis C Positive In The Emergency Department, Carson G. Swartz

DNP Projects

Background: Hepatitis C virus (HCV) is a blood-borne pathogen that can cause severe liver disease, cancer, and death and is a significant source of morbidity and mortality in the United States. Several academic medical centers including University of Kentucky Healthcare have implemented routine HCV screening for patients presenting to the emergency department (ED) and have discovered a large viral burden amongst patients who are often symptomatic.

Purpose: The purpose of this doctoral project is to increase staff compliance, confidence, and education regarding the HCV screening process in an urban, Level I emergency department, as well as to evaluate whether an …

Addressing The Inpatient Penicillin Allergy: Implementing A Nurse-Driven Allergy Assessment Tool To Enhance Antimicrobial Stewardship., Shelby Ryan Bliss

DNP Projects

Background: In an acute care setting, more than half the inpatient population receives antibiotics. Approximately 10% of the general population reports an allergy to penicillin. It has been replicated in the literature with data that of those who report a penicillin allergy, up to 95% are incorrectly identified. When a patient is admitted to the hospital with a penicillin allergy on their electronic health record, they are at higher risk for adverse events such as a hospital acquired infection, the occurrence of an antibiotic resistant bacteria related to receiving broader therapy and increased healthcare utilization.

Purpose: The purpose of this …

Structural Basis Of Bacterial Flagellin For Naip5 Binding And Nlrc4 Inflammasome Activation And The Mechanism Of Flagellin Induced Release Of Cytokines In Vivo, Jian Cui

Theses and Dissertations--Chemistry

The bacterial flagellum is a whip-like structure that protrudes from the cell membrane and is one of the most complex and dynamic biological molecular machines that propels bacteria to swim toward beneficial environments and the sites of infection. It is composed of a basal body, a hook, and a long filament. The flagellar filament contains thousands of copies of the protein flagellin (FliC) monomer arranged helically and ending with a filament cap composed of oligomer protein FliD. The overall structure of the filament core is preserved across bacterial species, while the outer domains exhibit high variability, and in some cases …

Mechanism Of Antibiotic Permeability Through The Gram-Negative Bacterial Envelope, Olaniyi Alegun

Theses and Dissertations--Chemistry

The outer membrane of Gram-negative bacteria (GN) makes them distinct among superbugs that are associated with the development of antibiotic resistance. The outer membrane, and inner membrane, separated by the periplasm, form a double-membrane barrier to the entry of antibiotics into the cell. Several studies have been conducted to examine the role of outer membrane modifications such as porins, lipopolysaccharides, and efflux pumps on antibiotic resistance. However, there is a paucity of knowledge on how antibiotics behave in the periplasm, to gain access into their target region. My thesis focuses on understanding the mechanism of antibiotic permeability through the cellular …

Antibiotic Permeation In Gram-Negative Bacteria And Contribution Of Inflammasome Activation And Pyroptosis In Pathogenesis Of Salmonella Systemic Infection, Ankit Pandeya

Theses and Dissertations--Chemistry

Antibiotic resistance is one of the major global issues in the field of public health and medicine. Good antibiotic candidates need to be selectively toxic, inhibit cellular target, and effectively penetrate and accumulate in bacterial cells. The last factor is a formidable barrier in the development of antimicrobials effective in Gram-negative bacteria, due to the presence of two layers of cell envelope. The first half of my thesis focuses on understanding the permeation of small molecules through this formidable cell envelope, distribution inside the cell of Gram-negative bacteria, and design of novel methods to make small molecules effectively cross the …

Cell-Engineered Vesicles For Therapeutic Delivery And Immunomodulatory Applications, Khaga Neupane

Theses and Dissertations--Chemistry

Development of a new kind of drug delivery system (DDS) that could efficiently deliver therapeutics to the cell of interest would allow us to accomplish cell-specific drug delivery while eliminating systemic toxicity. Although nanocarriers including endogenously released extracellular vesicles (EEVs), liposomes, and small molecules seem to be promising drug delivery systems, biological challenges persist for their use in clinical applications. Here, we demonstrate nanovesicles engineered by fragmenting cellular membranes can be exploited as versatile DDSs for therapeutics delivery as well as immunomodulatory functions. Cell-engineered vesicles were produced by cavitating cells using nitrogen gas at high pressure followed by serial centrifugation. …

Reported Barriers To Hepatitis C Treatment Among Pregnant And Early-Parenting Mothers Undergoing Substance Use Disorder Treatment In One U.S. State, Ayooluwatomiwa Deborah Adekunle, Kathi L. Harp, Zaynab G. Al-Abdali, Agatha S. Critchfield, Sheila Barnhart, Kathleen T. Winter

Health Management and Policy Faculty Publications

Nationwide, the prevalence of the hepatitis C virus (HCV) has risen in recent years. At least 90% of infected persons must be treated to achieve global elimination targets. The current study aimed to explore barriers to, and facilitators of, direct-acting antiviral (DAA) HCV treatment uptake amongst pregnant and early-parenting women undergoing comprehensive substance use treatment. Twenty participants with documented HCV antibody positivity were recruited from two substance use treatment centers in central Kentucky. Semi-structured interviews were conducted to explore knowledge about HCV, previous experiences, and intentions to seek care. Themes were extracted using an inductive analytical approach. Most participants were …