Medicine and Health Sciences Commons^™

Evaluation Of Educational Intervention And Management Of Patients With Type Ii Diabetes Mellitus, Elissa Johnson

DNP Projects

Background: Diabetes is a costly disease with devastating consequences. Patients with poor glucose control whether due to inadequate medical care or limited self-care are most at risk for complications. Evidence supports the efficacy of multifaceted interventions in the treatment of type II diabetes mellitus (T2DM). Patient education, assessing behavioral and psychosocial elements, and focusing on lifestyle change (e.g. diet and exercise) are interventions shown to enhance self-efficacy and promote patient empowerment (Knight, Dornan, & Bundy, 2005).

Study Design: A retrospective chart review of 104 patients with established T2DM was conducted along with a qualitative interview with providers focused on management …

Review Of Current Mobility Practice In Non-Surgical Mechanically Ventilated Intensive Care Unit Patients, Catharine Morgan

DNP Projects

Purpose: The purpose was to: (i) conduct a retrospective electronic medical record review to evaluate current practice related to mobility, (ii) determine the association between current mobility practice patterns and characteristics specific to the patient population, and (iii) make recommendations for the implementation of an evidence-based progressive early mobility protocol for non-surgical mechanically ventilated patients.

Population: Non-surgical, ventilated patients in the Intensive Care Unit (ICU)

Inclusion Criteria: Ventilated patients at least 18 years old who have been ventilated for at least 48 hours and did not have major surgery lasting more than one hour at any point during their hospital …

Evaluation Of Treatment For High Cholesterol And Prevention Of Cardiovascular Disease In Primary Care, Cristina Bolin

DNP Projects

Background Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in the United States and more than 610,000 people die every year from ASCVD related causes such as myocardial infarction (MI) or stroke. High cholesterol is one of the leading modifiable risk factors for prevention of ASCVD events. The 2013 American College of Cardiology/American Heart Association guidelines recommend treatment of high cholesterol as primary prevention for ASCVD in adults by lifestyle changes, CV risk estimation with an ASCVD calculator, and intensity dosing of statin medication. Effective strategies to support these recommendation exist in the clinical practice guidelines but evidence …

Evaluation Of Provider Recommendation Of Colorectal Cancer Screening In A Primary Care Setting, Emmanuel E. Nwaogu

DNP Projects

Objectives: The overall objective of this practice inquiry project was to evaluate whether providers in a primary care clinic in Louisville, KY were following the United States Preventive Services Task Force (USPSTF) screening guidelines regarding colorectal cancer for patients aged 50 -75. The study examined the types of screening recommended, and whether completion of screening was documented in the medical record. Finally in this study, provider recommendation for Colorectal Cancer Screening (CRC) was evaluated to determine if types of screening recommended, and documentation varied based on the ethnicity of the patients.

Methods: This was a descriptive study using a retrospective …

Equine Leptospirosis Seroprevealence In The Central And Bluegrass Regions Of Kentucky From 1993 - 2015, Charlene Siza

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

BACKGROUND

Leptospirosis is a worldwide zoonotic bacterial disease of significant importance for both human and animal health. There are many sources of infection and shedding of the bacteria, including horses. There is a known occupational hazard for leptospirosis, especially in occupations that work directly with animals or animal products. This study examined the prevalence of equine leptospirosis in Kentucky in relation to trends over time and geographical distribution.

METHODS

Data was obtained from the University of Kentucky Veterinary Diagnostic Laboratory(UKVDL) on equine leptospirosis from 1993 through September 2015. Overall seropositive prevalence and prevalence stratified by serovar were calculated. Furthermore, distribution …

Neurotoxic Effects Of Occupational Exposures In Agricultural Workers, Miriam Siegel

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

Background: Pesticides and organic solvents are two classes of neurotoxic substances regularly used in agriculture. Pesticides have been studied in relation to a range of nervous system effects, and have been repeatedly shown to relate to depression in agricultural workers. Likewise, occupational solvent exposure is recognized as a risk factor for central nervous system effects, including mood disturbances and cognitive impairment, across various industries. Many gaps in knowledge regarding the effects of chronic exposure to these substances on mental/neurological health in agricultural workers still exist. The specific aims of the current analysis were to 1.) Estimate associations between metrics of …

An Examination Of Traumatic Brain Injury As A Risk Factor For Psychiatric Symptoms In Alzheimer’S Disease Patients, Jennifer F. Walch

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

Introduction:

Dementia is a major public health issue both in the United States and worldwide. Alzheimer’s disease (AD) is widely considered to be the most prevalent type of dementia. While the hallmark AD symptom is profound memory loss, patients also commonly experience changes in personality and behavior. These changes often include depression, anxiety, social withdrawal, mood swings, irritability and aggression, changes in sleeping habits, and delusions.

Background:

Several studies have established a mechanistic link between traumatic brain injury (TBI) and the development of AD. However, it is unknown whether TBI contributes to the personality/behavior changes observed in many AD patients. …

Injuries Among Security And Law Enforcement Personnel In The Private Versus Public Sectors, William S. Witt

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

Background and Objectives: Data collected through workers’ compensation may be useful for occupational injury surveillance. This study examined whether differences existed between the public and private sectors of the security and law enforcement industry in Kentucky.

Methods: Using a cross-­‐sectional design, workers’ compensation data from the Kentucky Department of Workers’ Claims was analyzed to evaluate differences in demographic and injury characteristics, as well as award outcomes, stratified by industry sector. The dataset included all workers’ compensation first reports of injury and claims filed by security and law enforcement personnel in Kentucky from 2005 to 2015. Statistical analyzes included chi-­‐square and …

Evaluating The Use Of Second LifeTm For Virtual Team-Based Learning In An Online Undergraduate Anatomy Course, Christena Gazave

Theses and Dissertations--Medical Sciences

Team-based learning (TBL) is one strategy for improving team-work and critical thinking skills. It has proven to be an engaging teaching pedagogy in face-to-face classes, however, to our knowledge, has never been implemented online in a 3-D virtual world. We implemented virtual TBLs in an online undergraduate anatomy course using Second Life^TM, and evaluated whether it engaged students. This study was conducted over 2 semesters with 39 total students. Surveys and content analysis of transcripts were used to evaluate student engagement. Our results indicate virtual TBLs were engaging for most students. The average engagement score was 7.8 out …

The Role Of Sox4 In Regulating Choroid Fissure Closure And Retinal Neurogenesis, Wen Wen

Theses and Dissertations--Biology

The development of the vertebrate eye is tightly controlled by precise genetic regulations. From a single ocular primordium to bilateral eyes with complex structures and cell types, it requires intensive proliferation and migration for cells in both the ectoderm and mesoderm to accomplish ocular morphogenesis, and during this process cell differentiation and interaction takes place to establish the complex composition of ocular cell types and cellular connections. Genetic defects can lead to severe abnormalities in eye morphogenesis and cell differentiation during ocular development. A tremendous amount of work has been done to identify both intrinsic and extrinsic factors that regulate …

Exploration Of The Misuse, Abuse, And Diversion Of Gabapentin, Rachel Vickers Smith

Theses and Dissertations--Epidemiology and Biostatistics

Gabapentin is currently approved by the Food and Drug Administration (FDA) as an adjunctive anti-convulsant and an analgesic for post-herpetic neuralgia. Though gabapentin was initially presumed to have limited or no abuse potential, which may have contributed to its widespread off-label prescribing, there have been increasing anecdotal and published reports of its misuse by substance abusers in the community and penal system. However, to date, there has been limited systematic evaluation of the scope and risk of gabapentin misuse and its associated effects. This dissertation assesses the etiology and prevalence of gabapentin misuse, abuse, and diversion in a multi-faceted approach, …

Retrospective Frames Of Disability: Themes Derived From Parents Of Children Who Grew Up With Congenital Disability, Sheryl L. Holt

Theses and Dissertations--Rehabilitation Sciences

Introduction: For children born with physical disabilities, the perspectives and actions of their parents prove significant to their childhood developmental outcomes clinically, educationally, socially, and with regard to community participation. The lived world and perceptions of parents who have children with disabilities however is not well investigated. This study sought to understand parents’ framing of theirs and their children’s disability experiences. Family systems together with family systems intervention models, and disability theory were used to provide structure to interview instrumentation and subsequent analysis. Child-centered and ecologic influences were also used to track the transformative processes over time that infuses parental …

Temporal Neuromuscular Alterations Of The Quadriceps After Unilateral Anterior Cruciate Ligament Reconstruction, Conrad M. Gabler

Theses and Dissertations--Rehabilitation Sciences

Objective: The primary aim of this research was to examine the temporal pattern of neuromuscular quadriceps deficits in both the involved and uninvolved limbs of patients assigned to the control group after anterior cruciate ligament reconstruction (ACLr), by assessing quadriceps strength, voluntary activation, and corticomotor excitability prior to surgery (baseline), three months after ACLr, and six months after ACLr. A secondary aim of this research was to determine whether quadriceps strength, voluntary activation, and/or corticomotor excitability assessed in patients prior to ACLr and/or at three months after surgery, is predictive of lower extremity postural control and/or self-reported function at six …

Investigating The Efficacy Of Vocal Function Exercises In Improving Vocal Function In Adults Irradiated For Laryngeal Cancers: A Three Part Dissertation, Vrushali Angadi

Theses and Dissertations--Rehabilitation Sciences

Deterioration in voice quality following radiation therapy for the treatment of laryngeal cancers (LC) is well documented in literature. The majority of studies show that these voice problems are long term and in some cases permanent. Deterioration in voice quality, especially over a period of time could lead to significant communication difficulties in daily life or in some cases could even result in loss of profession. Despite the negative effects of radiation therapy on voice quality being well documented, few studies have focused on the efficacy of voice therapy in the irradiated LC population.

The purpose of this study was …

Prospective Assessment Of Return To Pre-Injured Levels Of Activity, Aaron D. Sciascia

Theses and Dissertations--Rehabilitation Sciences

Determining return to pre-injured levels of play following athletic injury can be challenging. The current practice of making decisions following rehabilitation as to whether or not a patient has returned to pre-injured levels of activity is potentially inaccurate because initial assessments of perceived physical capability are performed at a time of relative dysfunction or are based on patient recall. Since there is no true baseline of perceived and physical function prior to injury it is difficult to determine if an athlete has return to baseline or is simply better than they were at the time of injury. Therefore, it is …

Vocalization Subsystem Responses To A Temporarily Induced Unilateral Vocal Fold Paralysis, Daniel J. Croake

Theses and Dissertations--Rehabilitation Sciences

Healthy voicing is thought to be dependent on a dynamic balance of three interactive subsystems: respiration, phonation, and resonance. Theoretically, multiple patterns of subsystem interactions likely underlie healthy voice production; however surprisingly little quantitative data exists defining the nature of these subsystem production patterns and interactions across individuals.

The central aim of this study was to quantify the interactions of the vocalization subsystems in a non-perturbed and perturbed condition (induced unilateral vocal fold paralysis) in 10 vocally healthy participants. Respiratory inductance plethysmography, laryngeal aerodynamics, and acoustic formant data were used to measure the proportional contributions of, and changes to, the …

The Effect Of Nicotine Co-Administration On Alcohol-Induced Reactive Hippocampal Cell Proliferation During Abstinence In An Adolescent Model Of An Alcohol Use Disorder, Megan Heath

Theses and Dissertations--Pharmacy

A significant consequence of alcohol use disorders (AUDs) is hippocampal neurodegeneration. The hippocampus is responsible for learning and memory, and neurodegeneration in this brain region has been shown to result in cognitive deficits. Interestingly, some alcoholics demonstrate improvements in hippocampus-dependent functions, potentially due the phenomenon termed adult neurogenesis. Adult neurogenesis, the process by which neural stem cells (NSCs) proliferate, differentiate into neurons, migrate into the granule cell layer, and survive, occurs in two brain regions; however, this study examines only neurogenesis occurring in the subgranular zone of the hippocampal dentate gyrus. Four-day binge ethanol exposure in an animal model causes …

Development Of Cocaine Hydrolase For Therapeutic Treatment Of Cocaine Abuse, Xiabin Chen

Theses and Dissertations--Pharmacy

Cocaine abuse is a world-wide public health and social problem without a U.S. Food and Drug Administration (FDA)-approved medication. An ideal anti-cocaine medication would accelerate cocaine metabolism producing biologically inactive metabolites by administration of an efficient cocaine-specific exogenous enzyme. Recent studies in our lab have led to discovery of the desirable, highly efficient human cocaine hydrolases (hCocHs) that can efficiently detoxify and inactivate cocaine without affecting normal functions of central nervous system (CNS). Preclinical and clinical data have demonstrated that these hCocHs are safe for use in humans and effective for accelerating cocaine metabolism. However, the actual therapeutic use of …

Towards Elucidation Of The Mechanism Of Biological Nanomotors, Zhengyi Zhao

Theses and Dissertations--Pharmacy

Biological functions such as cell mitosis, bacterial binary fission, DNA replication or repair, homologous recombination, Holliday junction resolution, viral genome packaging, and cell entry all involve biomotor-driven DNA translocation. In the past, the ubiquitous biological nanomotors were classified into two categories: linear and rotation motors. In 2013, we discovered a third type of biomotor, revolving motor without rotation. The revolving motion is further found to be widespread among many biological systems. In addition, the detailed sequential action mechanism of the ATPase ring in the phi29 dsDNA packaging motor has been elucidated: ATP binding induces a conformational entropy alternation of ATPase …

Rna As A Unique Polymer To Build Controllable Nanostructures For Nanomedicine And Nanotechnology, Hui Li

Theses and Dissertations--Pharmacy

RNA nanotechnology is an emerging field that involves the design, construction and functionalization of nanostructures composed mainly of RNA for applications in biomedical and material sciences. RNA is a unique polymer with structural simplicity like DNA and functional diversity like proteins. A variety of RNA nanostructures have been reported with different geometrical structures and functionalities. This dissertation describes the design and construction of novel two-dimensional and three-dimensional self-assembled RNA nanostructures with applications in therapeutics delivery, cancer targeting and immunomodulation. Firstly, by using the ultra-stable pRNA three-way junction motif with controllable angles and arm lengths, tetrahedral architectures composed purely of RNA …

The Use Of Gesture In Self-Initiated Self-Repair Sequences By Persons With Non-Fluent Aphasia, Eleanor M. Feltner

Theses and Dissertations--Linguistics

This study examines the relationship between types of gestures and instances of self-initiated self-repair (SISR) used by persons with non-fluent aphasia (NFA), which is a type of aphasia characterized by stilted speech or signing (Papathanasiou et al., 2013), in interactions with clinicians. Conversation repairs in this study are assessed using the framework of Conversation Analysis (CA), which is an approach for describing, analyzing, and understanding social interaction (Sidnell, 2010). Previous linguistic studies have demonstrated a distinct preference for the use of gesture during a repair by persons with aphasia (Goodwin, 1995; Klippi, 2015; Wilkinson, 2013). This study draws more conclusive …

Comprehensive Sexuality Education In Kentucky, Luciana D. Hockersmith

Theses and Dissertations--Community & Leadership Development

Discussions of sex education of any kind can be controversial in a given setting. Traditional approaches to sex education prompt debate regarding effectiveness. Key indicators central to the effectiveness of sex education continue to be rates of teen pregnancy and transmission of sexually transmitted diseases (STDs). With discontentment surrounding the effectiveness of “traditional approaches,” a more wide-ranging method is worthy of being explored. The curriculum approach of Comprehensive Sexuality Education (CSE) includes six key concepts, and subsequent sub-concepts, intended to provide a broad and even all-inclusive range of topics for a similarly broad and even all-inclusive range of ages of …

Reducing Depression Among Older Adults: Informal Helping Versus Volunteering, Salih Salihoglu

MPA/MPP/MPFM Capstone Projects

Volunteerism is an unpaid productive activity that is exercised within a formal organization to benefit others that are not part of family or friends (Musick & Wilson, 2008). Alternatively, individuals could engage in informal helping which would be an activity undertaken outside a formal, structured organization. This paper addresses whether informal helping is also effective in reducing depression for older adults alongside volunteering. I hypothesize that informal helping is effective in reducing depression only when exercised for short durations. On the other hand, I hypothesize that volunteerism is only effective when exercised for long periods of time. I try to …

Determinants Of An Individual's Suicide Intention In South Korea, Nam Keun Choi

MPA/MPP/MPFM Capstone Projects

This study has examined a variety of variables that influence an individual’ s suicide intention, and analyzed the impact of these variables. The data are from the 2014 wave of the Korea Welfare Panel Survey (KoWePS). I analyze data on 13,687 out of 17,134 survey participants.

The dependent variable of my study is suicide intention such as suicidal thoughts and behaviors. The independent variables are classified into three categories: socio-demographic, psychological and mental health. Socio-demographic variables are gender, age, education, marital status, and income. Psychological variables are self-esteem, satisfaction with life, and religion. Mental health variables are depression, alcohol use, …

Across The States: Do Long Term Services & Supports Policies Affect The Number Of Nursing Home Residents With Low-Care Needs?, Mary Otis

MPA/MPP/MPFM Capstone Projects

Long term care for the elderly has been steadily gaining salience in the public policy realm for many years. The federal government has been vigorously studying and exploring solutions, including the Centers for Medicare and Medicaid Services’ (CMS) efforts to expand access to home and community-based services (HCBS) in order to reduce dependence on institutional care. These federal efforts include various incentive programs and policies recently offered under the Affordable Care Act. However, data on the strength of each state’s long term services and supports system has not been easily accessible until recently. The report “Raising Expectations: A State Scorecard …