Digital Commons Network^™

Pharmacists' Role In Harm Reduction: A Survey Assessment Of Kentucky Community Pharmacists' Willingness To Participate In Syringe/Needle Exchange, Amie Goodin, Amanda Fallin-Bennett, Traci Green, Patricia R. Freeman

Nursing Faculty Publications

Background: Pharmacists' role in harm reduction is expanding in many states, yet there are limited data on pharmacists' willingness to participate in harm reduction activities. This study assessed community pharmacists' willingness to participate in one harm reduction initiative: syringe/needle exchange.

Methods: In 2015, all Kentucky pharmacists with active licenses were emailed a survey that examined attitudes towards participation in syringe/needle exchange. Response frequencies were calculated for community pharmacist respondents. Ordinal logistic regression estimated the impact of community pharmacist characteristics and attitudes on willingness to provide clean needles/syringes to people who inject drugs and to dispose of used syringes/needles, where both …

Willingness-To-Pay For Attributes Of Health Care Facilities In Rural Kentucky, Emmanuel Owusu-Amankwah

Theses and Dissertations--Agricultural Economics

Background: As rural hospitals in Kentucky face insolvency, stakeholders must assess the value of rural hospitals as well as alternatives such as rural clinics and private physician offices.

Objective: To identify the value of attributes of healthcare facilities based on Kentucky’s rural residents’ willingness-to-pay (WTP).

Methods: A survey instrument was created and distributed to ten counties in rural Kentucky. A conditional logit model was used to obtain baseline values and then a mixed logit model was used to address heterogeneity among consumers in estimating WTP. WTP values incorporated respondents’ demographic characteristics and their health status from self-reported frequency of use …

Biosynthetic Mechanism Of The Antibiotic Capuramycin, Erfu Yan

Theses and Dissertations--Pharmacy

A-102395 is a member of the capuramycin family of antibiotics which was isolated from the culture broth of Amycolatopsis sp. SANK 60206. A-102339 is structurally classified as a nucleoside antibiotic, which like all members of the capuramycin family, inhibits bacterial MraY (translocase I) with IC₅₀ of 11 nM which is the lowest among the capuramycin family. A semisynthetic derivative of capuramycin is currently in clinical trials as an antituberculosis antibiotic, suggesting high potential for using A-102395 as a starting point for new antibiotic discovery. In contrast to other capuramycins, A-102395 has a unique arylamine-containing polyamide side chain. The biosynthetic …

Select Antimicrobial Resistance Trends In Kentucky’S Bovine Population And Antibiogram Development, Jessica Morehouse

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

Introduction: Antimicrobial resistance (AMR) is a complex problem that affects all of society and is driven by many interconnected factors. It is important to monitor AMR trends in veterinary medicine to accurately pursue appropriate antibiotic treatment of ill animals. Antibiogram development is also an important tool in guiding the veterinary practitioner in treating empirically or while a culture and susceptibility is being performed.

Methods: This study compared bacterial susceptibility in voluntary samples submitted to the University of Kentucky Veterinary Diagnostic Laboratory and the Murray State University Breathitt Veterinary Center between 2012 and 2017. Equality of proportions was used to compare …

Health Promotion In Elementary School Students, Madelyn J. Miles

Lewis Honors College Capstone Collection

The following project was created to address the rising epidemic of childhood obesity. Childhood obesity is caused by many factors such as genetics, metabolism, community and neighborhood design, diet, exercise, and short sleep duration (Center for Disease Control: Childhood Obesity Facts). Social determinants of health, systems of oppression, and stigma can all influence the obesity epidemic. These include but are not limited to social status, location, culture, age, sexuality, ethnicity, and race. These identities can influence affordability and access to healthcare and further contribute to the obesity epidemic. It is important to understand these issues as a future provider. A …

Ictv Virus Taxonomy Profile: Partitiviridae, Eeva J. Vainio, Sotaro Chiba, Said A. Ghabrial, Edgar Maiss, Marilyn Roossinck, Sead Sabanadzovic, Nobuhiro Suzuki, Jiatao Xie, Max Nibert, Ictv Report Consortium

Plant Pathology Faculty Publications

The Partitiviridae is a family of small, isometric, non-enveloped viruses with bisegmented double-stranded (ds) RNA genomes of 3–4.8 kbp. The two genome segments are individually encapsidated. The family has five genera, with characteristic hosts for members of each genus: either plants or fungi for genera Alphapartitivirus and Betapartitivirus, fungi for genus Gammapartitivirus, plants for genus Deltapartitivirus and protozoa for genus Cryspovirus. Partitiviruses are transmitted intracellularly via seeds (plants), oocysts (protozoa) or hyphal anastomosis, cell division and sporogenesis (fungi); there are no known natural vectors. This is a summary of the International Committee on Taxonomy of Viruses (ICTV) …

Cgas Drives Noncanonical-Inflammasome Activation In Age-Related Macular Degeneration, Nagaraj Kerur, Shinichi Fukuda, Daipayan Banerjee, Younghee Kim, Dongxu Fu, Ivana Apicella, Akhil Varshney, Reo Yasuma, Benjamin J. Fowler, Elmira Baghdasaryan, Kenneth M. Marion, Xiwen Huang, Tetsuhiro Yasuma, Yoshio Hirano, Vlad Serbulea, Meenakshi Ambati, Vidya L. Ambati, Yuji Kajiwara, Kameshwari Ambati, Shuichiro Hirahara, Ana Bastos-Carvalho, Yuichiro Ogura, Hiroko Terasaki, Tetsuro Oshika, Kyung Bo Kim, David R. Hinton, Norbert Leitinger, John C. Cambier, Joseph D. Buxbaum, M. Cristina Kenney, Bradley D. Gelfand, Jayakrishna Ambati

Ophthalmology and Visual Science Faculty Publications

Geographic atrophy is a blinding form of age-related macular degeneration characterized by retinal pigmented epithelium (RPE) death; the RPE also exhibits DICER1 deficiency, resultant accumulation of endogenous Alu-retroelement RNA, and NLRP3-inflammasome activation. How the inflammasome is activated in this untreatable disease is largely unknown. Here we demonstrate that RPE degeneration in human-cell-culture and mouse models is driven by a noncanonical-inflammasome pathway that activates caspase-4 (caspase-11 in mice) and caspase-1, and requires cyclic GMP-AMP synthase (cGAS)-dependent interferon-β production and gasdermin D-dependent interleukin-18 secretion. Decreased DICER1 levels or Alu-RNA accumulation triggers cytosolic escape of mitochondrial DNA, which engages cGAS. Moreover, caspase-4, gasdermin …

The Opioid Epidemic And Rural American: Why The Usda Should Lead The Response, Lexy Gross

Kentucky Journal of Equine, Agriculture, & Natural Resources Law

No abstract provided.

Mindfulness And Multiple Sclerosis, Mandakini Sadhir

Pediatrics Faculty Publications

Multiple sclerosis is a chronic, debilitating autoimmune condition with unknown etiology. It can have significant impact on quality of life and overall sense of wellbeing. It can be associated with poor sleep, fatigue, mental health disorders such as anxiety, depression and affect interpersonal relationships. Impact of mindfulness based interventions in mental health conditions, chronic illness as well as multiple sclerosis in adults has been widely studied. Several studies have concluded that mindfulness based intervention can be beneficial in improving quality of life, mental health and physical symptoms such as fatigue in adult patients with multiple sclerosis. Current literature suggest that …

Dairy Cattle Hoof Disease Costs And Considerations For Prevention, Karmella A. Dolecheck

Theses and Dissertations--Animal and Food Sciences

Lameness is considered one of the most important health and welfare issues in the dairy industry. Understanding the total cost per case of disease-specific lameness can help producers select better treatment, prevention, and control strategies for their herds. The first objective of our research was to calculate the costs associated with 3 lameness causing hoof diseases: digital dermatitis, sole ulcer, and white line disease. To accomplish this, a survey of hoof health professionals (hoof trimmers and veterinarians) was conducted to identify treatment related expenditures per case. Data from the hoof trimmer responses to the survey and previously published research were …

Assessment Of The Serum Amyloid A Assay For Diagnosing Disease In Neonatal Foals, Samantha W. Strouss

Theses and Dissertations--Animal and Food Sciences

Diagnosing disease in equine neonates poses a challenge for the equine industry because of the nonspecific manifestations of many diseases and the rapid deterioration that occurs. The differential diagnostic procedure requires many laboratory tests, whose results take days to receive. Serum amyloid A (SAA) is the only major acute phase protein identified in the horse; it exists in low levels in the healthy horse and increases over 100 fold in response to inflammatory stimulus 6-8 hours post stimulus. A point of care test allows veterinarians to obtain a SAA concentration within minutes that indicates the existence of infection. Being able …

Implementation Of An Evidenced-Based Opioid Treatment Program To Improve Maternal-Child Outcomes In Eastern Kentucky, Jordan Rice

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

The Kentucky River Area District Health Department proposes implementation of CHARM-Kentucky, a treatment program for pregnant women with opioid use disorder (OUD), in eastern Kentucky. Over 115 Americans die each day from an opioid overdose, resulting in approximately 42,000 deaths in 2016. In addition to an overall increase in opioid use in recent years, the use of opioids in pregnancy has also increased from 1.19 per 1,000 hospital births in 2000 to 5.63 in 2009. Opioid use during pregnancy results in poor neonatal outcomes including: low birth weight, preterm delivery, small head circumference, increased child maltreatment, and risk for long-term …

An Assessment Of Agreement In Detection Methods For Histophilus Somni In Bovine Lungs, Laura Michelle Arnold

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

Objectives: To examine the inter-laboratory agreement between multiplex realtime quantitative polymerase chain reaction (qPCR) assay results and aerobic culture results on bovine lung samples for detection of Histophilus somni (HS), and to assess associations of laboratory-derived factors on test agreement.

Methods: A survey of records from the University of Kentucky Veterinary Diagnostic Laboratory (UKVDL) was conducted to evaluate test results from grossly pneumonic bovine lung samples submitted during the period April 1, 2015 through August 31, 2018. Cohen’s kappa coefficient with 95% confidence interval (CI) was calculated to describe the extent of agreement. Animal, environmental and laboratory factors were examined …

Autonomic Dysreflexia After Spinal Cord Injury: Systemic Pathophysiology And Methods Of Management, Khalid C. Eldahan, Alexander G. Rabchevsky

Physiology Faculty Publications

Traumatic spinal cord injury (SCI) has widespread physiological effects beyond the disruption of sensory and motor function, notably the loss of normal autonomic and cardiovascular control. Injury at or above the sixth thoracic spinal cord segment segregates critical spinal sympathetic neurons from supraspinal modulation which can result in a syndrome known as autonomic dysreflexia (AD). AD is defined as episodic hypertension and concomitant baroreflex-mediated bradycardia initiated by unmodulated sympathetic reflexes in the decentralized cord. This condition is often triggered by noxious yet unperceived visceral or somatic stimuli below the injury level and if severe enough can require immediate medical attention. …

Identifying Veterans With Opioid Use Disorder That Could Benefit From Referral For Evidence-Based Medication-Assisted Treatment, Emily Hampton

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

Current treatment guideline recommendations published by the American Society of Addiction Medicine for Opioid Use Disorder (OUD) include both psychotherapy and Medication- Assisted Treatment for optimal management of this chronic medical illness. Military veterans are at an increased risk for fatal outcomes related to opioid overdoses due to a higher prevalence of depression/Post-Traumatic Stress Disorder (PTSD) and self-medicated substance use compared to their civilian counterparts. Additionally, many have been diagnosed with OUD but are not being treated in accordance with current treatment recommendations.

In an effort to increase access to treatment and combat the opioid epidemic, the Lexington VA Medical …

Modeling The Impact Of 13rs-Hb358: Hpv Vaccination For School Entry In A High-Prevalence State, Stacy Lee Ware

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

Prophylactic cancer vaccination presents novel opportunities to improve the health and well-being of populations. Since the approval of a cervical cancer vaccine against human papillomavirus (HPV) in 2006, only three states have passed legislation adding it to their school-entry schedules of required vaccinations. Despite ample evidence of its safety and efficacy, the vaccine remains controversial, and national vaccination rates among both girls and boys remain low. Risk for HPV-related cancers varies by population, and Appalachian Kentucky has among the highest HPV-related morbidity and mortality in the nation. Annual attempts to pass HPV vaccine legislation in Kentucky have so far failed …

Using A Video Modeling-Based Intervention Package To Teach Hand Washing To Children With Autism, Ndaru Prapti

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

The purpose of this study was to teach four preschool children with autism spectrum disorder (ASD) to wash their hands independently using a video modeling-based intervention package. A research questions was asked: Is there a functional relation between a video modeling-based intervention package and increases in level and trend for washing hands independently? A multiple probe across participants design was used to answer this question. Results indicated that the intervention package had functional relation with the increase in level and trend of the three participants’ performance in washing hands. The intervention package of video modeling and least-to-most prompting was found …

Identifying Rates, Barriers And Facilitators For Hpv Vaccines In Children Ages 11-14 In A Kentucky Primary Care Clinic, Sarah J. King

DNP Projects

Background: Among all of the pediatric vaccinations recommended by the CDC, the HPV vaccination has consistently had lower adherence rates than the goal set by Healthy People 2020. The CDC recommends that adolescents start receiving the human papillomavirus (HPV) vaccine at the ages 9-11 to provide protection against certain strains of HPV that can cause cancer. The goal is to administer the HPV vaccine before the adolescent would be exposed to the virus. However, there has been much resistance and non-adherence to the HPV vaccination. Purpose: The purpose of this study was to identify the current rates of HPV vaccination …

Alternatively Activated Macrophages In Pseudomonas Aeruginosa Pneumonia: Modulation Of The Nf-Κb Signaling Pathway And The Immunomodulatory Role Of Arginase-1, Dalia Haydar

Theses and Dissertations--Pharmacy

Background: Azithromycin polarizes macrophages into an alternative phenotype and promotes a regulated immunity. Arginase is an important effector of these macrophages believed to play an essential role in decreasing injury and promoting repair.

Hypothesis: Decreases in inflammation in response to Pseudomonas aeruginosa (PA) pneumonia achieved by polarizing macrophages to an alternative phenotype is dependent upon the production of arginase.

Methods: Requirement of arginase was examined by pharmacological inhibition using S-(2-boronoethyl)- l-cysteine (BEC) or l-norvaline and by infecting arginase-1 conditional knock-out mice (Arg1^flox/flox;Lyz2-cre (Arg1^Δm)) with PA intratracheally. Arg1^ΔM and control Arg1^flox/flox mice were then …

Discovery Of New Antimicrobial Options And Evaluation Of Aminoglycoside Resistance Enzyme-Associated Resistance Epidemic, Selina Y. L. Holbrook

Theses and Dissertations--Pharmacy

The extensive and sometimes incorrect and noncompliant use of various types of antimicrobial agents has accelerated the development of antimicrobial resistance (AMR). In fact, AMR has become one of the greatest global threat to human health in this era. The broad-spectrum antibiotics aminoglycosides (AGs) display excellent potency against most Gram-negative bacteria, mycobacteria, and some Gram-positive bacteria, such as Staphylococcus aureus. The AG antibiotics amikacin, gentamicin, kanamycin, and tobramycin are still commonly prescribed in the U.S.A. for the treatment of serious infections. Unfortunately, bacteria evolve to acquire resistance to AGs via four different mechanisms: i) changing in membrane permeability to …

Synthesis And Biological Evaluation Of Novel Drug Candidates To Address Drug Resistance In Tuberculosis And Fungal Diseases, Huy Ngo

Theses and Dissertations--Pharmacy

Tuberculosis (TB) and fungal infections are two of the most lethal infectious diseases worldwide due to the emergence of drug-resistant Mycobacterium tuberculosis (Mtb) and fungal strains that can resist the most potent antimicrobial drugs currently employed. Due to the rise of these drug resistant strains, effective treatment options for these two infections are limited. This dissertation aims at exploring novel drug scaffolds to help combat drug resistance in TB and fungal infections.

TB caused by the pathogenic Mtb is, alongside with human immunodeficiency virus acquired immunodeficiency virus (HIV), the deadliest infectious disease worldwide with approximately 2-3 billion people …

Rhodococcus Equi In The Foal – Improving Diagnostic And Prevention Measures, Fernanda Bicudo Cesar

Theses and Dissertations--Veterinary Science

Although Rhodococcus equi (R. equi), previously known as Corynebacterium equi, was first isolated from pneumonic foals almost a century ago, it remains the most common cause of subacute or chronic granulomatous bronchopneumonia in foals. While the majority of foals exposed to R. equi develop a protective immune response (regressors), others exhibit a unique susceptibility to infection (progressors). The determinants for either outcome are not completely understood. Therefore, current diagnostic and preventive measures are suboptimal and require betterment. In light of this current need, we hypothesized that immunoglobulin G subisotype T [IgG(T)] against the virulence-associated protein A (VapA) …

Effects Of Endophyte-Infected Tall Fescue Seed And Bromocriptine On Endocrine And Immune Function In Horses, Jessica Marie Hanneman

Theses and Dissertations--Veterinary Science

Consumption of endophyte-infected (E+) grasses has long been associated with health problems in animals. In cattle E+ tall fescue consumption leads to fescue toxicosis, and in horses it leads reproductive problems. The health-related issues associated with endophyte consumption have been attributed to the effects caused by the ergot alkaloids produced by the fungus. These ergot alkaloids are considered D2-like receptor agonists, and 5-HT2 serotonin and α-adrenergic receptor partial agonists. Many studies in humans, swine, cattle, and horses have identified that ergopeptines cause a decrease in prolactin production due to their dopaminergic activities. Additionally, these molecules have been found to cause …

Initial Assessment And Effects Of Snake Fungal Disease On Populations Of Snakes In Kentucky, Jennifer Mckenzie

Theses and Dissertations--Forestry and Natural Resources

Pathogenic fungi are increasingly associated with epidemics in wildlife populations and represent a significant threat to global biodiversity. Snake fungal disease is an emerging disease caused by the fungus, Ophidiomyces ophiodiicola, and appears to be widespread in the eastern United States. Yet an evaluation of field diagnostics, and an understanding of the population-level consequences of the disease, are lacking. First, I evaluated the use of clinical signs to predict the presence of O. ophiodiicola across season and snake habitat affiliation (aquatic or terrestrial) and I compared two sampling methods to see if collection method impacts PCR result. Overall, snakes with …

Cellular And Molecular Basis Of Equine Arteritis Virus Persistent Infection In The Stallion Reproductive Tract: Characterization Of Local Host-Pathogen Interactions Mediating Long-Term Viral Persistence, Mariano Carossino

Theses and Dissertations--Veterinary Science

Equine arteritis virus (EAV) has a global impact on the equine industry being the causative agent of equine viral arteritis (EVA), a reproductive, respiratory, and systemic disease of equids. A distinctive feature of EAV infection is that it establishes long-term persistent infection in the reproductive tract of stallions and is continuously shed in the semen (carrier state). Recent studies showed that long-term persistence is associated with a specific allele of the CXCL16 gene (CXCL16S). However, the cellular and molecular mechanisms underlying the establishment and maintenance of persistent infection are yet to be determined. The studies were undertaken herein …

Statistical Analysis Of Rabies Submissions In Kentucky And Weather As A Potential Predictor Of Positive Cases, Hannah Free

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

Background

The rabies virus is a zoonotic pathogen that is nearly 100 percent fatal once symptoms occur. Because it is still active in wildlife populations in Kentucky, the need for preventive measures and surveillance is critical. Temperature and precipitation have been shown to affect rabies. This study examined rabies submissions in Kentucky, weather and geographical distribution to both describe and predict cases.

Methods

Data from the University of Kentucky Veterinary Diagnostics laboratory were used to assess rabies submissions from 2005 through 2015. These submissions were anonymously submitted by the public and the Florescent Antibody Test was used to determine infection …

Improvement In Diagnosis Of Histoplasma Meningitis By Combined Testing For Histoplasma Antigen And Immunoglobulin G And Immunoglobulin M Anti-Histoplasma Antibody In Cerebrospinal Fluid, Karen C. Bloch, Thein Myint, Luke Raymond-Guillen, Chadi A. Hage, Thomas E. Davis, Patty W. Wright, Felicia C. Chow, Laila Woc-Colburn, Raed N. Khairy, Alan C. Street, Tomotaka Yamamoto, Amanda Albers, L Joseph Wheat

Internal Medicine Faculty Publications

Background. Central nervous system (CNS) histoplasmosis is a life-threatening condition and represents a diagnostic and therapeutic challenge. Isolation of Histoplasma capsulatum from cerebrospinal fluid (CSF) or brain tissue is diagnostic; however, culture is insensitive and slow growth may result in significant treatment delay. We performed a retrospective multicenter study to evaluate the sensitivity and specificity of a new anti-Histoplasma antibody enzyme immunoassay (EIA) for the detection of IgG and IgM antibody in the CSF for diagnosis of CNS histoplasmosis, the primary objective of the study. The secondary objective was to determine the effect of improvements in the Histoplasma galactomannan …

Stories Of Strength: Chicago Latin@S' Navigation Of Health, Well-Being, And Chronic Disease, Lilian L. Milanés

Theses and Dissertations--Anthropology

Health inequalities take many forms related to race, gender, socioeconomic status, ethnic, language and many other axes throughout communities around the world. Type two diabetes, high blood pressure, and high cholesterol are examples of conditions (among many others) that disproportionately affect Latino@s in the U.S.. The research of this dissertation is based on fieldwork conducted throughout several predominantly Latin@ neighborhoods in Chicago, IL. This dissertation examines how Latin@s in Chicago navigate health and well-being, and how they engage in agentive strategies in the face of chronic disease. I recorded individual life histories and semi-structured interviews, focus groups, and participant observation …

People Experiencing Homelessness Within Music Therapy Settings: A Descriptive Study, Amelia E. Ehmling

Theses and Dissertations--Music

The population of people experiencing homelessness has decreased less than 15% in the last ten years, but issues like mental illness and substance use are rising. There are many misconceptions about race, gender, location and age of people experiencing homelessness. Music therapy research about the homeless population is minimal and often focused on just one setting or treatment location. The purpose of this study was to better understand the relationship between music therapists and people experiencing homelessness. A survey of 365 music therapists in the United States revealed just under half of working clinicians provide services to people experiencing homelessness. …

The Effect Of An Educational Intervention On The Blood Culture Contamination Rate In Acutely Ill Adults, Kandace Vanhoozer

DNP Projects

PURPOSE: The purpose of this project was to assess the knowledge of nurses that collect blood culture specimens at University of Louisville Hospital and to implement an educational intervention among those nurses. It was expected that the educational intervention implemented for this project would increase nurses’ knowledge regarding the proper technique for blood culture specimen collection and decrease in the rate of contaminated blood cultures.

METHODS: This study included a prospective pre- and post-test of nursing knowledge followed by an educational intervention as well as a retrospective comparison of the pre- and post-education blood culture contamination rates.

RESULTS: Of the …