Medicine and Health Sciences Commons^™

An Analysis Of The Clear Horizons Program In Perry County, Kentucky On Smoking Cessation, Julia Kollitz

Lewis Honors College Thesis Collection

Perry County is an Appalachian county located in southeastern Kentucky. The population is 28,473 people (United States Census Bureau, 2020). It is a predominately white community, with 95.9% of people falling in this category, which is higher than the national percentage of 75.8% (United States Census Bureau, 2020). Being a rural county, this community uses few news sources, with the primary outlet being WYMT Eastern Kentucky News. This news outlet is a subset of CBS (WYMT, 2023). When comparing statewide and nationwide data, Perry County does consistently worse. They have a high school graduation rate that is lower than the …

Monetary Incentives For Producing Counterfeit, Adulterated, And Misbranded Medicine: Case Studies And Examples, Heather R. Campbell, Robert A. Lodder

Pharmaceutical Sciences Faculty Publications

Background: Pharmaceutical fraud can be very profitable. Those working in pharmaceuticals are in a tempting position as the nature of the product and supply is complex, making detection of fraud difficult and expensive. However, a reliable pharmaceutical supply can often be a life-or-death situation for patients. Thus, when detection of fraud occurs, a Regulator's Dilemma often emerges (recall a drug for which a supplier is the sole source, or allow a substandard product to be sold)—generally resulting in pharmaceutical companies receiving minimal penalties even for the worst acts. Despite pharmaceutical companies' unique leverage over regulators and profitability, studies are rare …

Improvisation As A Teaching Tool For Improving Oral Communication Skills In Premedical And Pre-Biomedical Graduate Students, Marianne Phelps, Catrina White, Lin Xiang, Hollie I. Swanson

Theatre and Dance Faculty Publications

Objective:

To evaluate the relationship between training in theatre improvisation and empathy, communication, and other professional skills.

Methods:

Undergraduate and graduate students who were participants of a 10-week summer undergraduate research program engaged in theatre improvisation techniques during a 3-hour workshop. In Study #1, a de-identified, self-report questionnaire (known as the Empathy Quotient) was administered prior to and following the workshop. Paired sample 2-tailed t-tests were performed to evaluate pre- and post-test scores. To identify additional benefits of engaging in theatre improvisation techniques, Study #2 was performed. Here, a survey was administered to the participants following their completion of …

Social Determinants Of Discrimination And Access To Health Care Among Transgender Women In Oregon, Jonathan Garcia, Richard A. Crosby

Health, Behavior & Society Faculty Publications

Purpose: Transgender women in the United States experience health disparities and limited access to gender-affirming health services. This study describes the social determinants of health that shape access to health services for transgender women in Oregon, a state with a high tally of gender-affirming policies.

Methods: We conducted qualitative interviews with 25 transgender women between 18 and 39 years of age. Interviews explored the social, economic, cultural, and legal factors that shape access to health. A Qualtrics survey captured sociodemographic characteristics. We identified facilitators and barriers to accessing gender-affirming services using thematic analysis of qualitative data.

Results: Our participants perceived …

Hooked On A Feeling: Influence Of Brief Exposure To Familiar Music On Feelings Of Emotion In Individuals With Alzheimer's Disease, Alaine E. Reschke-Hernández, Amy M. Belfi, Edmarie Guzmán-Vélez, Daniel Tranel

Music Faculty Publications

BACKGROUND: Research has indicated that individuals with Alzheimer's-type dementia (AD) can experience prolonged emotions, even when they cannot recall the eliciting event. Less is known about whether music can modify the emotional state of individuals with AD and whether emotions evoked by music linger in the absence of a declarative memory for the eliciting event.

OBJECTIVE: We examined the effects of participant-selected recorded music on self-reported feelings of emotion in individuals with AD, and whether these feelings persisted irrespective of declarative memory for the emotion-inducing stimuli.

METHODS: Twenty participants with AD and 19 healthy comparisons (HCs) listened to two 4.5-minute …

Psychosocial Mediators Of Perceived Stigma And Suicidal Ideation Among Transgender Women, Krishna Kiran Kota, Laura F. Salazar, Rachel E. Culbreth, Richard A. Crosby, Jamal Jones

Health, Behavior & Society Faculty Publications

BACKGROUND: Transgender women (TGW) in the U.S. experience high rates of stigma, depression, and elevated rates of suicide. This study examined correlates of suicidal ideation and estimated the conditional indirect effects of perceived stigma and psychosocial mediators on suicidal ideation.

METHODS: Using a cross-sectional study design, TGW (N = 92) were recruited through snowball sampling in Atlanta, Georgia. Structured interviews were conducted. Suicidal ideation was assessed by combining two variables that measured suicidal thoughts. Logistic regression models were performed to identify the potential risk and protective factors for suicidal ideation. We examined hypothesized psychosocial factors, including anxiety, depression, psychosocial impact …

Ethnic And Gender Disparities In The Uptake Of Transcatheter Aortic Valve Replacement In The United States, Ayman Elbadawi, Syed Yaseen Naqvi, Islam Y. Elgendy, Mohamed F. Almahmoud, Mohamed Hamed, Hesham Abowali, Gbolahan O. Ogunbayo, Hani Jneid, Khaled M. Ziada

Internal Medicine Faculty Publications

Introduction: Little is known about ethnic and gender disparities for transcatheter aortic valve replacement (TAVR) procedures in the United States.

Methods: We queried the Nationwide Inpatient Sample (NIS) database (2011–2014) to identify patients who underwent TAVR. We described the temporal trends in the uptake of TAVR procedures among various ethnicities and genders.

Results: Our analysis identified 39,253 records; 20,497 (52.2%) were men and 18,756 (47.8%) were women. Among all TAVRs, 87.2% were Caucasians, 3.9% were African Americans (AA), 3.7% were Hispanics, and 5.2% were of other ethnicities. We found a significant rise in the trend of TAVRs in all groups: …

Evaluation Of The Project P.A.T.H.S. In Mainland China: Findings Based On Student Diaries, Daniel T. L. Shek, Xiaoqin Zhu, Janet T. Y. Leung, Tak Yan Lee, Florence K. Y. Wu

Pediatrics Faculty Publications

Objectives: Based on 859 student diaries, the present study evaluated a positive youth development program entitled “Tin Ka Ping (TKP) Positive Adolescent Training through Holistic Social programs (P.A.T.H.S.) ” project implemented in mainland China during the 2015–2016 academic year. Method: To understand the perceived effectiveness of the students, the study analyzed quantitative as well as qualitative data derived from the student diaries. Results: The students held very positive views toward the program and the implementers. The narratives of the students also showed that they perceived improvement in the intrapersonal, interpersonal, familial, and societal domains after joining the program. Conclusion: In …

A Phewas Study Of A Large Observational Epidemiological Cohort Of African Americans From The Regards Study, Xueyan Zhao, Xin Geng, Vinodh Srinivasasainagendra, Ninad Chaudhary, Suzanne Judd, Virginia Wadley, Orlando M. Gutiérrez, Henry Wang, Ethan M. Lange, Leslie A. Lange, Daniel Woo, Frederick W. Unverzagt, Monika Safford, Mary Cushman, Nita Limdi, Rakale Quarells, Donna K. Arnett, Marguerite R. Irvin, Degui Zhi

Epidemiology and Environmental Health Faculty Publications

Background: Cardiovascular disease, diabetes, and kidney disease are among the leading causes of death and disability worldwide. However, knowledge of genetic determinants of those diseases in African Americans remains limited.

Results: In our study, associations between 4956 GWAS catalog reported SNPs and 67 traits were examined among 7726 African Americans from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, which is focused on identifying factors that increase stroke risk. The prevalent and incident phenotypes studied included inflammation, kidney traits, cardiovascular traits and cognition. Our results validated 29 known associations, of which eight associations were reported for the …

Fraud Detection Protocol For Web-Based Research Among Men Who Have Sex With Men: Development And Descriptive Evaluation, April M. Ballard, Trey Cardwell, April M. Young

Epidemiology and Environmental Health Faculty Publications

Background: Internet is becoming an increasingly common tool for survey research, particularly among “hidden” or vulnerable populations, such as men who have sex with men (MSM). Web-based research has many advantages for participants and researchers, but fraud can present a significant threat to data integrity.

Objective: The purpose of this analysis was to evaluate fraud detection strategies in a Web-based survey of young MSM and describe new protocols to improve fraud detection in Web-based survey research.

Methods: This study involved a cross-sectional Web-based survey that examined individual- and network-level risk factors for HIV transmission and substance use among young MSM …

Correlates Of Not Using Antiretroviral Therapy Among Transwomen Living With Hiv: The Unique Role Of Personal Competence, Richard A. Crosby, Laura F. Salazar, Brandon J. Hill

Health, Behavior & Society Faculty Publications

Purpose: This study tested three psychosocial measures for their potential to serve as counseling goals for promoting ART to transgender women living with HIV (TWLH).

Methods: Among 69 TWLH, 17.4% were not taking ART; these volunteers were compared to the remainder using multivariate regression analyses.

Results: Only one psychosocial measure achieved significance: Personal Competence (Adjusted Odds Ratio = 0.80, 95% CI = 0.67–0.97, P = 0.02). Because this was a continuous measure, assessed on a 7-point scale, the protective adjusted odds ratio of 0.80 represents a 20% reduction in the odds of not taking ART for each unit of increase …

Measuring Women's Empowerment In Sub-Saharan Africa: Exploratory And Confirmatory Factor Analyses Of The Demographic And Health Surveys, Ibitola O. Asaolu, Halimatou Alaofè, Jayleen K. L. Gunn, Akosua K. Adu, Amanda J. Monroy, John E. Ehiri, Mary H. Hayden, Kacey C. Ernst

Epidemiology and Environmental Health Faculty Publications

Background: Women's status and empowerment influence health, nutrition, and socioeconomic status of women and their children. Despite its benefits, however, research on women's empowerment in Sub-Saharan Africa (SSA) is limited in scope and geography. Empowerment is variably defined and data for comparison across regions is often limited. The objective of the current study was to identify domains of empowerment from a widely available data source, Demographic and Health Surveys, across multiple regions in SSA.

Methods: Demographic and Health Surveys from nineteen countries representing four African regions were used for the analysis. A total of 26 indicators across different dimensions (economic, …

Historical And Cross-Cultural Perspectives On Parkinson's Disease, Lee Xenakis Blonder

Sanders-Brown Center on Aging Faculty Publications

Parkinson’s disease (PD) is a common neurodegenerative disorder, affecting up to 10 million people worldwide according to the Parkinson’s Disease Foundation. Epidemiological and genetic studies show a preponderance of idiopathic cases and a subset linked to genetic polymorphisms of a familial nature. Traditional Chinese medicine and Ayurveda recognized and treated the illness that Western Medicine terms PD millennia ago, and descriptions of Parkinson’s symptomatology by Europeans date back 2000 years to the ancient Greek physician Galen. However, the Western nosological classification now referred to in English as “Parkinson’s disease” and the description of symptoms that define it, are accredited to …

Self-Reported Risk And Delinquent Behavior And Problem Behavioral Intention In Hong Kong Adolescents: The Role Of Moral Competence And Spirituality, Daniel T. L. Shek, Xiaoqin Zhu

Pediatrics Faculty Publications

Based on the six-wave data collected from Grade 7 to Grade 12 students (N = 3,328 at Wave 1), this pioneer study examined the development of problem behaviors (risk and delinquent behavior and problem behavioral intention) and the predictors (moral competence and spirituality) among adolescents in Hong Kong. Individual growth curve models revealed that while risk and delinquent behavior accelerated and then slowed down in the high school years, adolescent problem behavioral intention slightly accelerated over time. After controlling the background socio-demographic factors, moral competence and spirituality were negatively associated with risk and delinquent behavior as well as problem …

Promoting Cognitive Conflict In Health Care Ethics: Moral Reasoning With Boundary Cases, Julia Bursten, Samantha Finkelstein

Philosophy Faculty Publications

As many college students are at a time of tremendous personal and academic growth, introductory philosophy courses have the potential to equip students with practical critical reasoning skills. Despite this, many introductory courses in this domain emphasize students’ learning about pre-existing dialectics in the abstract, rather than over self-reflection and development of personal philosophical perspectives. In doing so, we may be failing to support the needs of pre-professional students looking to prepare themselves for their careers ahead. In this practitioner paper, we report our efforts as a practicing philosophy instructor (Bursten) and a learning scientist (Finkelstein) to iterate on the …

Other Tobacco Product Use Among Sexual Minority Young Adult Bar Patrons, Amanda Fallin-Bennett, Nadra E. Lisha, Pamela M. Ling

Nursing Faculty Publications

Introduction—Lesbian, gay, and bisexual (LGB) individuals smoke at rates 1.5–2 times higher than the general population, but less is known about LGB consumption of other tobacco products (OTPs) and gender differences. OTP use among young adult LGB bar patrons and the relationship among past quit attempts, intention to quit, and binge drinking with OTP use was examined.

Methods—A cross-sectional survey of young adults (aged 18–26) in bars/nightclubs in seven U.S. cities between 2012 and 2014 (N=8,010; 1,101 LGB participants) was analyzed in 2016. Logistic regressions examined current use of five OTPs (cigarillos, electronic cigarettes, hookah, chewing tobacco, and …

Challenges And Considerations Related To Studying Dementia In Blacks/African Americans, Eseosa T. Ighodaro, Peter T. Nelson, Walter A. Kukull, Frederick A. Schmitt, Erin L. Abner, Allison M. Caban-Holt, Shoshana H. Bardach, Derrick C. Hord, Crystal M. Glover, Gregory A. Jicha, Linda J. Van Eldik, Alexander X. Byrd, Anita Fernander

Neuroscience Faculty Publications

Blacks/African Americans have been reported to be ~2–4 times more likely to develop clinical Alzheimer’s disease (AD) compared to Whites. Unfortunately, study design challenges (e.g., recruitment bias), racism, mistrust of healthcare providers and biomedical researchers, confounders related to socioeconomic status, and other sources of bias are often ignored when interpreting differences in human subjects categorized by race. Failure to account for these factors can lead to misinterpretation of results, reification of race as biology, discrimination, and missed or delayed diagnoses. Here we provide a selected historical background, discuss challenges, present opportunities, and suggest considerations for studying health outcomes among racial/ethnic …

Is Sex With Older Male Partners Associated With Higher Sexual Risk Behavior Among Young Black Msm?, Nicholas Chamberlain, Leandro A. Mena, Angelica Geter, Richard A. Crosby

Health, Behavior & Society Faculty Publications

Participants at a sexual health clinic completed a survey with questions regarding sexual risk behavior and partner characteristics. Of 585 participants eligible for analysis, 124 reported generally having older male partners. These participants were significantly more likely to be HIV-infected (p < 0.001), have four or more sex partners as a “bottom” (p = 0.04), have concurrent partners (p = 0.01), and have partners suspected of having an sexually transmitted infection (p = 0.05) than participants without older partners. With analysis restricted to HIV− individuals, risk behaviors did not differ significantly between the groups. HIV− individuals with older partners may be at increased risk of HIV infection due …

Substance Use Disorders, Violence, Mental Health, And Hiv: Differentiating A Syndemic Factor By Gender And Sexuality, Kiyomi Tsuyuki, Eileen V. Pitpitan, Maria A. Levi-Minzi, Lianne A. Urada, Steven P. Kurtz, Jamila K. Stockman, Hilary L. Surratt

Center for Health Services Research Faculty Publications

This paper measures syndemic substance use disorder, violence, and mental health and compares the syndemic among HIV-infected heterosexual men, heterosexual women, and men who have sex with men (MSM). Data were from a sample of high needs substance-using, HIV-infected people in South Florida between 2010 and 2012 (n = 481). We used confirmatory factor analysis to measure a syndemic latent variable and applied measurement invariance models to identify group differences in the data structure of syndemic co-morbidities among heterosexual men, heterosexual women, and MSM. We found that variables used to measure the syndemic fit each sub-group, supporting that substance use …

Age Of First Arrest, Sex, And Drug Use As Correlates Of Adult Risk Behaviors Among Rural Women In Jails, Martha Tillson, Justin C. Strickland, Michele Staton

Center on Drug and Alcohol Research Faculty Publications

Incarcerated women frequently report initiation of substance use and sexual encounters at an early age, and often engage in high-risk drug use and sexual behaviors as adults. This study examined the timing of first sex, drug use, and arrest, as well as their unique influences on specific risky behaviors in adulthood, among a high-risk population of rural women recruited from jails. Ages of initiation were all positively and significantly correlated, and each independently increased the likelihood of several risky behaviors in adulthood. Implications are discussed for screening, intervention, and treatment targeting high-risk women and girls in rural areas, particularly within …

Evaluation Of A Community-Based Positive Youth Development Program For Adolescents With Greater Psychosocial Needs: Views Of The Program Participants, Daniel T. L. Shek, Cecilia M. S. Ma, Moon Y. M. Law, Zoe Zhao

Pediatrics Faculty Publications

The present study attempted to investigate the perceptions of Chinese secondary school students with greater psychosocial needs of the Tier 2 Program in the community-based phase of P.A.T.H.S. Project in Hong Kong (n=4245). Using a subjective outcome evaluation tool (Form C), the results revealed that a great majority of the students held positive attitudes toward the program, implementers and the effectiveness of the program. Also, the three domains of the program (“program quality”, “implementer quality” and “program effectiveness”) were significantly associated with each other. In line with previous findings, both program content and program implementer quality were significant predictors of …

Mental Health Treatment Seeking Patterns And Preferences Of Appalachian Women With Depression, Claire Snell-Rood, Emily Hauenstein, Carl G. Leukefeld, Frances Feltner, Amber Marcum, Nancy E. Schoenberg

Behavioral Science Faculty Publications

This qualitative study explored social-cultural factors that shape treatment seeking behaviors among depressed rural, low-income women in Appalachia—a region with high rates of depression and a shortage of mental health services. Recent research shows that increasingly rural women are receiving some form of treatment and identifying their symptoms as depression. Using purposive sampling, investigators recruited 28 depressed low-income women living in Appalachian Kentucky and conducted semistructured interviews on participants’ perceptions of depression and treatment seeking. Even in this sample of women with diverse treatment behaviors (half reported current treatment), participants expressed ambivalence about treatment and its potential to promote recovery. …

Psychological Needs, Self-Regulation, And Motivation Profiles Among A Sample Of Hong Kong Chinese University Students: A Person-Centered Approach, Cecilia M. S. Ma, Daniel T. L. Shek, Catie C. W. Lai

Pediatrics Faculty Publications

To better understand factors that influence individuals’ motivation to engage in physical activity, this study aimed to identify the motivational profiles among the Chinese university students, compare the motivational profiles between genders, and explore whether satisfaction of various psychological needs vary with different motivational profiles. Two thousand and twenty-two Chinese university students completed a battery of self-report questionnaires assessing motivation regulation and psychological needs satisfaction. Three motivational profiles were identified for both genders. The overall patterns of the motivational profiles for both genders were similar. However, males (44%) were more likely than their female counterparts (19%) in self-determined profile group. …

Correlates Of Sexual-Risk Behaviors Among Young Black Msm: Implications For Clinic-Based Counseling Programs, Richard A. Crosby, Leandro Mena, Janelle M. Ricks

Health, Behavior & Society Faculty Publications

This study applied an 8-item index of recent sexual-risk behaviors to young Black men who have sex with men (YBMSM) and evaluated the distribution for normality. The distribution was tested for associations with possible antecedents of sexual risk. YBMSM (N = 600), aged 16–29 years, were recruited from a sexually transmitted infection clinic, located in the southern US. Men completed an extensive audio computer-assisted self-interview. Thirteen possible antecedents of sexual risk, as assessed by the index, were selected for analyses. The 8-item index formed a normal distribution with a mean of 4.77 (SD = 1.77). In adjusted analyses, not …

Subjective Report Of Side Effects Of Prescribed And Nonprescribed Psychostimulant Use In Young Adults, Tess E. Smith, Michelle M. Martel, Alan D. Desantis

Psychology Faculty Publications

Background: Side effects of prescribed and nonprescribed psychostimulant use are understudied. Objectives: The study examined side effects of prescribed and nonprescribed psychostimulant use in a college sample with attention to possible gender differences. Methods: 2716 undergraduates (1448 male) between the ages of 17 and 57 years (M = 19.43 years, SD = 1.7 years) completed an online survey that included questions about the subjective side effects of prescribed and nonprescribed psychostimulant use. Results: Results suggested that prescribed users more frequently reported side effects, compared to nonprescribed users. For prescribed users, females more frequently reported appetite, somatic, and anxiety-related side …

Music Therapy As Procedural Support For Young Children Undergoing Immunizations: A Randomized Controlled Study, Olivia S. Yinger

Music Faculty Publications

Background: Children undergoing routine immunizations frequently experience severe distress, which may be improved through music therapy as procedural support.

Objective: The purpose of this study was to examine effects of live, cognitive-behavioral music therapy during immunizations on (a) the behaviors of children, their parents, and their nurses; and (b) parental perceptions.

Methods: Participants were children between the ages of 4 and 6 years (N = 58) who underwent immunizations, their parents (N = 62), and the nurses who administered the procedure (N = 19). Parent/child dyads were randomly assigned to receive music therapy (n = 29) …

Transylvania University And Its Hemp Connection, Charles T. Ambrose

Microbiology, Immunology, and Molecular Genetics Faculty Publications

No abstract provided.

Andreas Vesalius (1514-1564)–An Unfinished Life, Charles T. Ambrose

Microbiology, Immunology, and Molecular Genetics Faculty Publications

The fame of Andreas Vesalius (1514-1564) rests on his anatomy text, De humani corporis fabrica, regarded as a seminal book in modern medicine. It was compiled while he taught anatomy at Padua, 1537-1543. Some of his findings challenged Galen’s writings of the 2c AD, and caused De fabrica to be rejected immediately by classically trained anatomists. At age 29, Vesalius abandoned his studies and over the next two decades served as physician to Emperor Charles V of the Holy Roman Empire (HRE) and later to King Philip II of Spain in Madrid. In 1564, he sought to resume teaching anatomy …

Plagiarism Of Ideas. Benjamin Rush And Charles Caldwell--A Student-Mentor Dispute, Charles T. Ambrose

Microbiology, Immunology, and Molecular Genetics Faculty Publications

No abstract provided.

Grave Robbing In Lexington And Elsewhere, Charles T. Ambrose

Microbiology, Immunology, and Molecular Genetics Faculty Publications

No abstract provided.