Medicine and Health Sciences Commons^™

Alterations In Visual Processing And Its Impact On Upright Postural Stability In Athletes Following Sport-Related Concussion, Andrea E. Cripps

Theses and Dissertations--Rehabilitation Sciences

Athletes are at risk of sustaining a concussion in all sports and at all competitive levels which may lead to balance impairments. Balance results from the integration of visual, vestibular, and somatosensory information. The underlying pathophysiology for balance impairments is not well understood and visuo-motor processing impairments and how these impairments contribute to balance in concussed athletes has not been reported. Objectives: (1) to investigate the influence of visual perturbation on upright postural stability and balance in athletes who have recently suffered a sports-related concussion, (2) to establish the test-retest reliability of a simple visuo-motor processing task. Design: A longitudinal, …

Conviction Celerity, Punishment Severity, And Treatment Compliance As Predictors Of Dui Recidivism: Mediation And Moderation Models Of Deterrence, Megan F. Dickson

Theses and Dissertations--Sociology

Driving under the influence (DUI) is one of the most frequently committed offenses in the United States and approximately one-third of DUI offenders are recidivists. Researchers have evaluated multiple DUI prevention approaches, most of which have been rooted in deterrence theory. Recently, the criminal justice system has moved away from deterrence-based approaches and begun employing various forms of rehabilitation to reduce DUI recidivism. This shift in the criminal justice system has lead researchers to begin exploring the effects of rehabilitation on DUI offenders, including an examination of offender compliance with rehabilitation programs. Although each of these areas has been investigated …

Untangling Neoliberalism’S Gordian Knot: Cancer Prevention And Control Services For Rural Appalachian Populations, George F. Bills

Theses and Dissertations--Sociology

In eastern Kentucky, as in much of central Appalachia, current local storylines narrate the frictions and contradictions involved in the structural transition from a post-WWII Fordist industrial economy and a Keynesian welfare state to a Post-Fordist service economy and Neoliberal hollow state, starving for energy to sustain consumer indulgence (Jessop, 1993; Harvey, 2003; 2005). Neoliberalism is the ideological force redefining the “societal infrastructure of language” that legitimates this transition, in part by redefining the key terms of democracy and citizenship, as well as valorizing the market, the individual, and technocratic innovation (Chouliaraki & Fairclough, 1999; Harvey, 2005). This project develops …

Expression Of Borderline Personality Disorder Symptoms Across The Ovulatory Cycle: A Multilevel Investigation, Tory A. Eisenlohr-Moul

Theses and Dissertations--Psychology

Borderline Personality Disorder (BPD) is a disabling condition characterized by chronic emotion dysregulation and behavioral impulsivity. Prospective studies that test proposed mechanisms of within-person change in BPD hold the key to improving symptom predictability and control in this disorder. A small body of evidence suggests that fluctuations in estradiol such as those occurring naturally at ovulation during the monthly female reproductive cycle may increase symptoms in women with BPD (DeSoto et al., 2003). Furthermore, there is preliminary evidence that both self-esteem and feelings of social rejection are highest at ovulation, when estradiol peaks (Durante and Hill, 2009; Eisenlohr-Moul et al., …

Student-Athletes And Drug Abuse Policies: A Study Of Drug Abuse Policies Of Athletics Departments In A Major Intercollegiate Athletics Conference, Jennifer Hale

MPA/MPP/MPFM Capstone Projects

No executive summary.

Kentucky Pharmacist Opinions Of The Potential Reclassification Of Pseudophedrine As A Legend Drug, Kathleen E. Monson

MPA/MPP/MPFM Capstone Projects

Methamphetamine is a drug of abuse, which is often produced in clandestine laboratories. Recent efforts to curb methamphetamine abuse are aimed at controlling access to precursors, including pseudoephedrine (PSE), used in illicit methamphetamine production. Currently, access to PSE is controlled in Kentucky by placement behind pharmacy counters, retail quantity limitations and electronic tracking. Recent legislation proposed in Kentucky to change PSE from non-prescription to a legend medication was unsuccessful and highly controversial. The objective of this project is to collect and analyze pharmacists’ opinions on the effectiveness of current precursor controls, proposed legislation to make PSE a legend drug and …

Psychotropic Medication Utilization In Care Home Residents Age 65 Or Older Compared With The Equivalent General Population In Scotland, Tyler P. Stewart

MPA/MPP/MPFM Capstone Projects

Purpose: In Scotland, care homes provide assisted living and medical services. Psychotropic medications (antipsychotics, anxiolytics, and hypnotics) may be over utilized in these facilities. This study compared psychotropic medication utilization in elderly care home residents to the equivalent population of non-care home residents. It is hypothesized that patients in care homes utilize psychotropic medications more than non-care home residents.

Methods: Demographic and prescription information for all patients aged 65 years and older on January 1, 2011 who received at least one prescription for a psychotropic medication during 2011 was retrieved from the national Prescribing Information System (PIS). Patients were grouped …

Relationship Between Clandestine Methamphetamine Laboratory Seizures And Burns In Kentucky, David A. Wittmer

MPA/MPP/MPFM Capstone Projects

Methamphetamine is a highly addictive stimulant that is synthetically produced using equipment and chemicals available in the community. Its burden to society may be determined through a number of mechanisms, including the imposed strain on healthcare systems. The evolution of methamphetamine use and production methods has led to reports of increased methamphetamine related burn admissions among hospital burn units[1-3] . Current literature identifies an increase in injury severity, comorbid complications, and cost of care associated with methamphetamine related burn injuries[1-5]. The intent of this study is to identify burn injuries in Kentucky and assess whether a statistically significant association exists …

Veterinary Specialty Certification: Analyzing The Value Of Certification Through The American Board Of Veterinary Practitioners, Jeff Allen

MPA/MPP/MPFM Capstone Projects

When it comes to professional certification a number of potential benefits can be cited by the organizations that offer them. Self-improvement, recognition by peers, public benefit and enhanced career opportunities are just a few of the frequently mentioned values associated with certification programs. This study was conducted to identify the primary benefits of certification for the American Board of Veterinary Practitioners (ABVP) by recording and analyzing the perceived value of ABVP certification within the veterinary community. An online survey was developed to collect data from ABVP certified and non-certified veterinarians, relying heavily on the Perceived Value of Certification Tool (PVCT). …

Age, Attention, And Ots In A Constrained Vs Unconstrained Task, Courtney Leann Jensen

Theses and Dissertations--Rehabilitation Sciences

The discourse of older healthy adults is commonly described as lengthy and off-topic and thought to be associated with a general cognitive decline that occurs in healthy aging. This study investigated the overall decline in attention associated with healthy aging and its relationship to instances of off-topic speech (OTS) in a constrained and unconstrained language production task. Ninety cognitively healthy adults participated and comprised three age cohorts (40 – 75+). Participants completed cognitive measures of attention and two discourse tasks that included recounting personal events and describing a procedure. Older adults exhibited poorer scores on measures of selective and shifting …

Explaining Benefit Utilization Variability In Fmnp In Kentucky: An Application Of Pierre Bourdieu’S Theory, Stephanie M. Holcomb-Kreiner

Theses and Dissertations--Sociology

Research has demonstrated the crucial role fresh fruit and vegetable consumption plays in maintaining good health. However, most Americans do not consume adequate amounts, and low-income Americans consume the lowest quantities of fresh fruits and vegetables. The Farmers’ Market Nutrition Program (FMNP) and Senior Farmers’ Market Nutrition Program (SFMNP) attempts to rectify this situation by providing vouchers to low-income women, children, and elders that can be used only at farmers’ markets for the purchase of locally grown, fresh fruits and vegetables. Unfortunately, FMNP and SFMNP exhibit variable and often low benefit utilization. This variable and often low benefit utilization is …

Decision-Making Processes And Health Behaviors Among Adults Diagnosed With Schizophrenia, Lillian J. Findlay

Theses and Dissertations--Nursing

Individuals diagnosed with schizophrenia commonly experience problems with accurately assessing their health status due to cognitive deficits including impaired working memory, amotivation, and communication difficulties. Little is known about whether these deficiencies influence health behavior decision-making among individuals with schizophrenia. Individuals with schizophrenia die an average of 25 years earlier than those without a mental illness. Approximately 60% of premature deaths in this population are from medical comorbidities; mortality rates due to cardiovascular and pulmonary diseases are two to three times higher than the general population. In order to reduce morbidity and mortality, it is important to find effective ways …

Cross-Cultural Comparison Of Perceptions About School Feeding Programs From Ghanaian And U.S. Adults, Yolanda L. Jackson

Theses and Dissertations--Nutrition and Food Systems

Because of an increase in food insecurity over the past decade, the U.S. and many developing countries are focusing efforts on issues relating to child hunger. School feeding programs have been in existence for roughly 220 years but modifications have been made over the years to improve the quality of food they serve. Little research has been conducted about adult perceptions of school feeding programs and the impact it has on the community in the U.S. as well as developing countries such as Ghana, West Africa. Because of the gap in literature on school feeding programs and adult perceptions about …

The Relationship Of Social Stress, Economic Hardship, And Psychological Distress To Addiction Severity Among Kentucky Substance Abuse Treatment Participants, Elizabeth A. Wahler

Theses and Dissertations--Social Work

Stress is associated with poor mental health, specifically anxiety and depression, and stress and mental health problems are predictors of substance dependence and relapse. Social characteristics, such as racial/ethnic minority status, female gender, and low socioeconomic status, are often associated with increased psychological distress and substance use disorders. Pearlin’s social stress theory postulates that this association is due to increased exposure to stress and subsequent experiences of distress related to social disadvantage and decreased access to resources for coping with stress. This project uses a social stress theoretical perspective to examine predictors of substance use after treatment entry and follow-up …

Attentional Bias And Alcohol Abuse, Jessica Jane Weafer

Theses and Dissertations--Psychology

Selective attention towards alcohol-related cues (i.e., “attentional bias”) is thought to reflect increased incentive motivational value of alcohol and alcohol cues acquired through a history of heavy alcohol use, and as such attentional bias is considered to be a clinically relevant factor contributing to alcohol use disorders. This dissertation consists of two studies that investigated specific mechanisms through which attentional bias might serve to promote alcohol abuse. Study 1 compared magnitude of attentional bias in heavy (n = 20) and light (n = 20) drinkers following placebo and two doses of alcohol (0.45 g/kg and 0.65 g/kg). Heavy drinkers displayed …

Influence Of Prescription Drug Monitoring Programs On Acetaminophen-Related Liver Toxicity, Aaron Barcelo

MPA/MPP/MPFM Capstone Projects

No executive summary.

Influence Of Medical Marijuana Programs On Controlled Substance Utilization, James A. Farley Ii

MPA/MPP/MPFM Capstone Projects

Currently there are no studies examining the impact of medical cannabis programs on controlled substance prescribing. The intent of this study is to conduct a preliminary investigation into whether cannabis substitution for prescription drugs results in lower rates of controlled substance use. The hypothesis is that controlled substance use (in this project, defined by controlled substance supply) will decline in states after the introduction of medical cannabis programs.

State and year–specific per capita retail distributions of the seven most commonly prescribed opioid drugs (fentanyl, hydrocodone, hydromorphone, meperidine, methadone, morphine, and oxycodone) were obtained from the Automation of Reports and Consolidated …

Polyamine Modulation In Alcoholism: Examination Using A Novel Screening Procedure Designed To Predict Anti-Relapse And Neuroprotective Efficacy, J. Ben Lewis

University of Kentucky Doctoral Dissertations

Alcohol dependence is a major public health concern. Despite the FDA’s approval of multiple anti-relapse drugs, relapse rates remain unacceptably high. Furthermore, cognitive deficits among chronic drinkers are evident and are suggested to contribute to relapse risk. Current evidence suggests that several critical features of alcoholism and alcohol-associated neurodegeneration are mechanistically linked to glutamatergic actions; specifically, they appear positively affected by glutamatergic inhibition, particularly inhibition via polyamine modulation of a subpopulation of n-methyl-d-aspartate receptors. The current project was designed to evaluate the performance of two putative polyamine modulators (JR-220 and CP-101,606) in a variety of screens designed …

Intrapsychic Predictors Of Professional Quality Of Life: Mindfulness, Empathy, And Emotional Separation, Jacky T. Thomas

University of Kentucky Doctoral Dissertations

A growing literature documents the inherently stressful nature of working with persons who are suffering or traumatized, and the potential for the development of stress disorders among social workers and other helpers. Previous studies of compassion fatigue and burnout have provided important information about professional and workplace variables that might influence risk, but little attention has been given to studying intrapersonal skills/abilities that might reduce risk and/or increase resilience and work satisfaction among helping professionals. This exploratory study asked whether levels of mindfulness, empathy, and emotional separation would influence professional quality of life, including compassion fatigue, burnout, and compassion satisfaction. …

Structures, Roles And Relationships Within Public Health’S Response To The 2009-2010 H1n1 Outbreak: The Ties That Bind Public Information Officers And Emergency Risk Communication Efforts, Kathleen G. Vidoloff

University of Kentucky Doctoral Dissertations

Little is known about the role of public health public information officers (PIOs) during public health emergencies. This study uses interpretative methods to learn about the organizational structures that facilitate and constrain emergency risk communication efforts during public health emergencies. Interpretive thematic comparative analysis of PIOs experiences and reflections about their involvement in the 2009-2010 H1N1 response will be used to illustrate how social interactions between and among PIOs, public health staff, and representatives from other agencies create implicit and explicit structures that facilitate and constrain emergency risk communication. The application of three specific concepts from structuration theory, namely, agent, …

Should Pseudoephedrine (Pse) Be Moved From Behind The Counter To Prescription-Only? An Analysis Of Pse As An Otc Medication And A Precursor For Methamphetamine Production, Jerry Dillon

MPA/MPP/MPFM Capstone Projects

Kentucky State Senator Tom Jensen recently sponsored Senate Bill 45, which would change pseudoephedrine (PSE) from an over-the-counter to a schedule V prescription-only drug. The bill failed, but the debate continues as to whether Kentucky should make PSE, a precursor required to manufacture illicit methamphetamine, a controlled drug that is available by prescription only.

Methamphetamine abuse has been increasing in Kentucky as well as in the rest of the country, despite efforts to control the sale of PSE through federal and state legislation. The Combat Methamphetamine Epidemic Act (CMEA) of 2006 and Kentucky’s initiative to electronically monitor the sales of …

Dental Service Utilization In An Academic Setting: An Analysis For Improved Oral Health, Paula R. Sandford

MPA/MPP/MPFM Capstone Projects

The National Oral Health Surveillance System (NOHSS) is the result of a collaborative effort between the Centers for Disease Control and Prevention and the Association of State and Territorial Dental Directors which is designed to monitor aspects of oral health and disease on both a national and state level. The NOHSS ranks Kentucky at or near the bottom in most oral health indicators. The primary message of the Surgeon General’s May 2000 report on Oral Health in America was to emphasize the link between oral health and overall health including the effect on day‐to‐day activities such as work and school …

The Incidence Of Hip Fracture Associated With Proton Pump Inhibitor (Ppi) And/Or H2 Receptor Antagonist (H2ra) Use In The Kentucky Medicaid Population, Timothy C. Umeh

MPA/MPP/MPFM Capstone Projects

No executive summary.

Tobacco-Free Prison Policies And Health Outcomes Among Inmates, Alison R. Connell

University of Kentucky Doctoral Dissertations

This study was the first to examine the effect of tobacco policies in prisons on the health of inmates. Kentucky has two types of tobacco policies in its 16 state prisons: indoor smoke-free policies, where smoking is allowed outdoors and tobacco-free policies, in which no tobacco of any kind is allowed on the grounds of the prison. The smoking rate of inmates is three times higher than that of current smokers in the non-incarcerated population which results in high rates of tobacco-related health conditions such as heart disease and lung cancer.

A literature review discussed the evolution of tobacco policies …

Essays On Human Capital, Health Capital, And The Labor Market, Charles Hokayem

University of Kentucky Doctoral Dissertations

This dissertation consists of three essays concerning the effects of human capital and health capital on the labor market. Chapter 1 presents a structural model that incorporates a health capital stock to the traditional learning-by-doing model. The model allows health to affect future wages by interrupting current labor supply and on-the-job human capital accumulation. Using data on sick time from the Panel Study Income of Dynamics the model is estimated using a nonlinear Generalized Method of Moments estimator. The results show human capital production exhibits diminishing returns. Health capital production increases with the current stock of health capital, or better …

Executive Deficits In Amyotrophic Lateral Sclerosis: Examining The Consequences Of Self-Regulatory Impairment On Quality Of Life, Abbey R. Roach

University of Kentucky Doctoral Dissertations

Amyotrophic Lateral Sclerosis (ALS) is a fatal neurodegenerative disease that attacks the motor system and contributes to a range of cognitive and behavioral impairments (e.g., behavioral and emotional disinhibition, planning and problem solving difficulties, impulsivity, attention, and personality change). This executive dysfunction may contribute to selfregulatory impairment across several domains, including cognitive skills, thought processes, emotion regulation, interpersonal skills, and physiology, that may be crucial to the quality of life (QOL), or well being, of patients and their caregivers. Given the relentless course and prognosis of ALS, palliative treatments for ALS should target the full range of self-regulatory deficits. Thirty-seven …

Screen Door Medicine: The Informal Medical Consultation, Debra Faith Nickell

University of Kentucky Doctoral Dissertations

This study explores the phenomenon of the informal medical consultation, a communication event in which an individual asks for medical information, advice, or care from an off-duty health professional with whom the individual has no formal patient-provider relationship. Using surveys and interviews, the study describes these consultations from the perspective of the health care professional and the informal patient. The study explores foundational theories that offer explanations for the phenomenon. The theories considered include social support, decision-making, social exchange, perceived partner responsiveness to needs, and uncertainty management.

This study suggests health care providers perceive informal medical consultations to be more …

What Nurses Say: Communication Behaviors Associated With The Competent Nursing Handoff, Anne Claiborne Ray Streeter

University of Kentucky Doctoral Dissertations

Communication competence and medical communication competence served as the theoretical framework for this research that seeks to identify specific communication behaviors associated with what nurses say constitute a communicatively competent patient handoff at the nursing change of shift. Data collected from 286 nurses responding to an online modified Medical Communication Competence Scale posted at www.allnurses.com supported the hypotheses that information exchange (information giving, seeking and verifying) and socioemotional communication behaviors are rated more highly in the best patient handoffs than in the worst ones. Research questions found that the incoming nursing role rated behaviors associated with information verifying and socioemotional …

Social Categories And Health Care Outcomes: African American Women And Hiv Survival In The Urban South, Alyson J. O'Daniel

University of Kentucky Doctoral Dissertations

This ethnographic research examines the daily life and institutional conditions under which low-income Black women in urban North Carolina perceived and attended to HIV health-related needs. I focus specifically on the interplay among women’s living conditions, programmatic service needs, and their strategies for navigating the local system of care to explore and refine the categorical label “low income.” I found that there were significant differences among study participants in terms of their monthly incomes and financial resources, housing quality and status, and personal experiences with incarceration and substance abuse. The economic differences among women translated into social differences within the …

The Cost Of Medication Errors In The Emergency Department: Implications For Clinical Pharmacy Practice, Benjamin Bowman

MPA/MPP/MPFM Capstone Projects

Introduction

The main purpose of this capstone project is to provide an objective analysis of the cost of a medication error in the emergency department. The secondary objective of this analysis is to estimate the cost avoidance impact of providing clinical pharmacy services in the emergency department (ED).

Literature review

Previous literature has described the scope of clinical pharmacy services in the ED and has, to some extent, presented economic outcomes analyses of the impact of these services (Cohen et al., 2009; Lada and Delgado, 2007). According to Cohen et al., the current literature is still lacking a formal pharmacoeconomic …