Medicine and Health Sciences Commons^™

Prevalence And Exacerbation Of Asthma Within Two Counties In Eastern Kentucky, Rachid Souleye

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

Background: Central Appalachia residents have one of the highest rates of serious respiratory diseases in the nation. Appalachian Kentuckians are 50% more likely to be diagnosed with adult asthma compared to the overall U.S. population. Yet, few epidemiologic studies have assessed risk factors for respiratory disease in this population. Using a community-based approach, the investigators of the Mountain Air Project (MAP), one of the largest adult cohorts from two disadvantaged communities in Central Kentucky, collected data to estimate the prevalence of asthma and assess various socioeconomic and environmental risk factors to determine their effect on asthma.

Methods: A cross-sectional epidemiologic …

Impact Of Mental Health And Financial Status Of Essential And Non-Essential Workers That Continued Working Outside The Home During The Spring 2020 Covid-19 Shutdown, Adrianne Deveira

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

Objective: A global pandemic caused businesses in the United States to shutdown based on essential vs. non-essential criteria. There has been a lot of research discussing the impact of the shutdown on healthcare frontline workers. Little is known about other essential and non-essential workers, that continued working outside the home during the shutdown. The purpose of this paper is to examine the financial and mental health issues encountered by essential and non-essential workers that continued working outside the home during the Spring 2020 shutdown.

Methods: Snowball sampling of an online survey that was available from May 8 – June 6, …

Methenamine Prophylaxis For Recurrent Urinary Tract Infections In A Tertiary Referral Center, Cameron A. Wade

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

Purpose: Methenamine hippurate (MH) is a urinary antiseptic, indicated for prophylaxis of recurrent urinary tract infections (UTIs) but with only few and limited studies regarding its efficacy. To help address this knowledge gap we reviewed our experience with MH for UTI prophylaxis, focusing on women with recurrent uncomplicated UTIs.

Materials and Methods: The University of Kentucky electronic health record was queried to identify adults who were prescribed MH from the Urology clinic between January 2013 and January 2019. Charts were reviewed to assess patient-reported UTI frequency, demographics and relevant health factors. Treatment success was defined as 0-1 UTI in 6 …

Injuries Among Distillery Workers: Workers' Compensation First Reports Of Injury, 2010-2019, Mira Hali Mirzaian

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

AIMS: To identify the most frequent type, nature, and cause of work-related injury amongst distillery workers as well as contributing factors to the injurious event in an effort to inform potential intervention.

METHODS: Workers’ Compensation First Reports of Injury (FROI) from the years 2010-2019 (N=974) were obtained. Variables were created for ‘occupational category’ and ‘accident description’ to assist in the elucidation of the injurious event. The Ratchet Circular Scan Test was used to assess seasonal variation in injury. Kernal Density Analysis was conducted to assess rates of injury by calendar year.

RESULTS: Amongst injured distillery workers, 908 of the injuries …

Healthy Living People: A Hiv Transmission Intervention In Four Chicago Communities, Angela Wuerger

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

The transmission of HIV within the city of Chicago has been established as a major health concern: however, the lack of adequate resources has created gaps within current programming available for people living with HIV. Healthy Living People (HLP) is an evidence-based program focused on reducing the transmission of HIV through strengthening adherence to antiretroviral therapy and decreasing number of higher risk sexual encounters. The Chicago Department of Public Health will provide the HLP program, which includes fifteen 90-minute sessions over the course of one year. The HLP program will be offered for people living with

HIV in four Chicago …

Can Treatment Of Social Isolation And Loneliness Reduce Healthcare Utility? An Analysis Of Social Prescribing, Matthew Mattingly

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

The paper focuses on the practice of social prescribing as it is currently implemented through the National Health Service (NHS) of the United Kingdom. Social Prescribing is an emerging healthcare intervention aimed at referring patients to community-based activities. NHS promotes social prescribing as a method of reducing healthcare utilization in chronically ill patients. Current evidence on social prescribing is subject to significant variation and has not supported NHS’s claims. The potential link between feeling of social isolation, loneliness and chronic illness was further investigated through data from the National Social Life, Health & Aging Project (NSHAP). Data was tested for …

Rabies In Kentucky From 1989-2020: A Case For Surveillance, Sarah Jane Robbins

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

The Kentucky rabies reporting system includes data from five laboratories and provides an account of suspected rabies reports since 1989. Over 35,000 suspected cases are used to estimate rabies incidence temporally and spatially. Recommendations to the current rabies reporting methodologies are presented through proposed innovations of a standard, electronic reporting form. Given the multiple sources of data, the reporting system lacks standardization and comprehensive information about suspected rabies events, resulting in limited epidemiological capabilities; and data issues that prevent its use as a surveillance system. These issues are a limiting factor in rabies elimination; but a driving factor in over-testing, …

Implementation Of A School-Based Sexual Health Curriculum For Fayette County, Kentucky Public Schools, Laura P.H. Bellnier

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

Adolescents in the United States are vulnerable to negative sexual health outcomes such as unplanned pregnancy and sexually transmitted infections (STIs) due to a high prevalence of risky sexual behaviors in this population. Research demonstrates that providing adolescents with comprehensive sexuality education that addresses sexual health knowledge, attitudes, and behaviors can increase protective behaviors, such as condom use and decrease negative health outcomes over the long term. Implementing a comprehensive sexuality education program in a public school setting is an effective strategy to reach a large number of adolescents and targeting early adolescents can influence student sexual health knowledge, attitudes, …

Volatile Organic Compound Exposure And Hearing Loss In Children, Brooke Spillman

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

Hearing loss is often associated with repeated exposure to noise levels above 85 decibels. While noise is noted as the largest contributor to hearing loss, some fail to consider the impacts of chemical exposure on the hearing health of children, specifically VOCs. Early detection and prevention of hearing loss in children is important due to the impacts that hearing has on the learning, behavior, speech, and language development of children. This study examined the relationship between VOC exposure and hearing loss in children using NHANES data collected from 2005-2006. This was analyzed with Chi-square analyses and a logistic regression taking …

Maternal Residential Proximity To Surface Mining Associated With Preterm Birth And Low Birth Weight In Appalachian Kentucky, Whitney Smith

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

Objective: This study aims to examine the relationship between maternal residency in a county with surface coal production and preterm birth or low birth weight.

Methods: A cross-sectional study was conducted using birth records (n=62,766) for 54 Appalachian counties and coal production in tons. Logistic regression and chi-squared analysis was done to analyze the relationship between surface coal mining and preterm birth and low birth weight in two different birth groups.

Results: After controlling for covariates, statistically significant increases were seen in Birth Group 1 and Birth group 2. Birth Group 1 had statistically significant results for preterm birth ((1.19 …

The Effect Of The Affordable Care Act On The Ability Of Health Departments In The Appalachian Regions To Offer Primary Care Services, Ogechi Anyagaligbo

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

In the Appalachian region, the need for primary care services has increased due to an increase in morbidity rates from coal mining, obesity, drugs, and poor health care. The Affordable Care Act (ACA) was enacted in part to expand access to patient care. The ACA aimed to help solve these problems and help underdeveloped communities such as the ones in the Appalachian region that do not have access to affordable and quality health care. This project examines differences before and after the ACA was passed on the delivery of primary care services by local health departments within the Appalachian region. …

The Impact Of Kentucky's Medicaid Expansion Under The Affordable Care Act On Dental Care Visits, Mutlaq Alotaibi

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

Background. Lack of health insurance, cost of dental care services, and shortage of dental workforce are leading barriers to dental care access. Low-income adults and those who reside in areas with low dentist supply are less likely to visits a dental office than their counterparts. Studies have reported that dental visits increased among low-income adults in states that expanded Medicaid under the Affordable Care Act (ACA) and have an adequate number of dentists. However, the impact of Medicaid expansion on income-based disparities and urban-rural disparities in dental care visits is unclear.

Objectives. The aim of this study is to examine …

Healthy, Fit, & Strong: A Parent-Child Physical Activity Program For Families With Obese And Overweight Adolescents, Patrick Maloney

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

Over 20% of Kentucky children between the ages of 10-17 are obese, the third highest prevalence in the nation. The Healthy, Fit, & Strong Program works with children with a BMI above the 85th percentile and their parents to improve behaviors related to physical activity (PA) and nutrition. The intervention is a 12-week program which features tri-weekly physical activity sessions and nutrition classes. Both children and parents participate in activities in order to build knowledge and confidence related to healthy behaviors. The goal of this intervention is to improve upon baseline physical activity levels and diet as well as to …

Alcohol Excise Taxes And Their Effects On The Community, Christopher R. Watts

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

Objectives: This study examines the association of an additional excise tax on alcoholic beverages in Georgetown, Kentucky with alcohol-related motor vehicle accidents. Evaluate the additional benefits of the excise tax on the community of Georgetown, Kentucky.

Methods: Using an interrupted time series design, this study compares alcohol-related crash statistics from two similar cities based on 126 months of data from the Kentucky State Police. Analyses included linear regression and Poisson models to evaluate the data in each city to determine population-wide results.

Results: Alcohol-related motor vehicle crashes immediately declined (-12.5%) in Georgetown following the implementation of the excise tax and …

Mitigating Opioid Related Healthcare Use In Kentucky: An Assessment Of The Impact Of Kentucky Revised Statute (Krs) Changes To Opioid Prescribing On Opioid Related Prescribing And Healthcare Utilization, Drew Speer

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

The opioid epidemic has impacted few other places more than the state of Kentucky. In 2018, data from the Centers of Disease Control and Prevention (CDC) and the National Institute on Drug Abuse (NIDA) ranked Kentucky as being in the top ten for rate of drug overdose deaths and opioid-involved overdose deaths per 100,000 persons.^1,2 These rankings exist even though prescription opioid dispensing rates have fallen from 102.6 per 100 persons in 2015 to 72.3 per 100 persons in 2019.³ Aligning with this trend, while research shows this problem began with prescription opioids in the late 1990’s, it …

Risk Factors Of Carbapenem-Resistant Enterobacteriaceae Acquisition Among Adult Intensive Care Unit Patients At A Kentucky Academic Medical Center, Jason Eric Wilson, Jason Wilson

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

Background: This study aimed to identify risk factors of carbapenem-resistant Enterobacteriaceae (CRE) acquisition among adult intensive care unit (ICU) patients at a Kentucky academic medical center and to evaluate sink drains as a possible environmental reservoir of carbapenem-resistant organism (CRO) transmission.

Methods: A retrospective cohort study was conducted from October 1, 2013 through October 31, 2016. Intensive care unit patients were screened for CRE at admission and weekly until discharge. Cases were defined as patients who tested positive for CRE on ICU admission day 3 or greater. Sink drains were sampled for CROs in selected units from January 2018 through …

Assessment Of The University Of Kentucky's Nutrition Education Program's Smarter Lunchrooms Pilot Plate Waste Project In Three Kentucky Schools, Natalie Jones

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

School-based approaches utilizing policy, systems, and environmental strategies are needed to address the complex factors driving childhood obesity. The purpose of this pilot study is to implement Smarter Lunchroom strategies in three participating Kentucky middle schools in 2019 and then assess two outcomes: (1) determine the impact of the intervention on fruit and vegetable purchases and waste, and (2) determine how purchases or waste varied by interventions selected for each setting. After the 6-week intervention, combined we found no statistical significant increases in fruit and vegetable purchasing from pre to post-intervention. No statistical significant decreases in fruit and vegetable plate …

An Evaluation Of Injurious Falls And Fall-Risk-Increasing-Drug (Frid) Prescribing Behaviors In A Nationally Representative Sample & The Pharmacist’S Role In Fall Prevention, Taylor Elliott, Susan Westneat, Shama Karanth, Erin Abner, Anna Kucharska-Newton, Daniela C. Moga

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

Background: Falls are a major public health problem affecting millions of older adults each year. Little is known about FRID prescribing behaviors after injurious falls occur.

Objective(s): The primary objective of this study was to investigate whether an injurious fall impacts the odds of being prescribed a new FRID.

Methods: We conducted a cross-sectional analysis using data from the 2016 National Ambulatory Medical Care Survey to investigate whether an injurious fall impacts the odds of being prescribed a new FRID. We included patients age >/= 65 years and classified visits based on presence of an injurious fall. The outcome of …

The Characterization Of Purified Citrate-Coated Cerium Oxide Nanoparticles Prepared Via Hydrothermal Synthesis, Matthew L. Hancock, Robert A. Yokel, Matthew J. Beck, Julie L. Calahan, Travis W. Jarrells, Eric J. Munson, George A. Olaniyan, Eric A. Grulke

Chemical and Materials Engineering Faculty Publications

Hypothesis

Cerium oxide nanoparticles were synthesized using a hydrothermal approach with citric acid as a stabilizing agent. Citric acid adsorption onto the nanoceria particle surface can cease particle formation and create a stable dispersion for an extended shelf life. The product was dialyzed immediately following the synthesis to remove unreacted cerium that could contribute to biological effects. Nanoparticle characterization results are expected to help identify the surface citrate bonding structure.

Experiments

Many characterization techniques were utilized to determine size, morphology, surface properties, and citrate complexation on the nanoceria particle surface. These included transmission electron microscopy, electron energy loss spectroscopy, dynamic …

The Interactive Effects Of Brain-Derived Neurotrophic Factor (Bdnf) Polymorphisms And Posttraumatic Stress Disorder On Neurocognitive Functioning In U.S. Military Veterans, Colton Shafer Rippey

Theses and Dissertations--Psychology

Posttraumatic Stress Disorder (PTSD) is associated with mild-to-moderate deficits in neurocognitive functioning. Single nucleotide polymorphisms (SNPs) in the brain-derived neurotrophic factor (BDNF) gene, namely, the Met allele, may also be associated with mild deficits in neurocognitive functioning. However, findings are inconsistent and may be sensitive to environmental epigenetic moderators such as psychopathology.

The current study analyzed data from European-American U.S. military veterans (n = 1,244) who participated in the 2011 National Health and Resilience in Veterans Study (NHRVS). Multivariate analyses of covariances were conducted to evaluate the unique and interactive effects of the Met allele and probable PTSD on …

Other People’S Families: How Social Ties Shape Entrance Into The Medical Profession, Lillian Sims

Theses and Dissertations--Educational Policy Studies and Evaluation

Not enough members of low-income, rural, and minoritized populations are successfully prepared for and recruited into medical school, exacerbating issues of unequal access to healthcare and limiting access to the profession. While a multitude of factors contribute to this problem, early social exposure to others in a field can act as a key contributor to career interest and a key advantage for entering the profession. Meanwhile, students without early social exposure to healthcare may take unconventional paths to medical school or may struggle to fit into the unique culture of medicine when they do enter training, especially if they belong …

A Biochemical Characterization Of The Fusion Proteins From Enveloped Rna Viruses, Chelsea T. Barrett

Theses and Dissertations--Molecular and Cellular Biochemistry

Enveloped viruses must bind target cells and then fuse the viral membrane with a cell membrane to enter a host cell. These viruses use one or more surface glycoproteins to carry out these critical functions. The surface glycoprotein that carries out the fusion function, termed a fusion protein, is divided into three classes based on structural similarities. Some of the most studied human viral pathogens, such as human immunodeficiency virus (HIV), Ebola virus, influenza, measles, and the recently emerged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), possess class I fusion proteins. Following synthesis, class I fusion proteins associate as non-covalently …

Entry And Early Infection Of Non-Segmented Negative Sense Rna Viruses, Jean Mawuena Branttie

Theses and Dissertations--Molecular and Cellular Biochemistry

Paramyxoviruses, pneumoviruses, and other non-segmented negative sense (NNS) RNA viruses have historically been of public health concern. Although their genomes are typically small (up to 19kbs) they are able to inflict large-scale detrimental pathologies on host cells. Human metapneumovirus (HMPV) is a widespread pathogen and is a NNS RNA virus. HMPV results respiratory tract infections and is particularly dangerous for preterm infants, the elderly, and immunocompromised individuals. Other viruses within the NNS RNA virus order include the deadly Ebola, Hendra, and Nipah viruses (EBOV, HeV, and NiV), as well as the re-emerging measles virus (MeV). Despite their public impact, there …

Therapeutic Targeting Of Leukemia Stem Cells To Prevent T-Cell Acute Lymphoblastic Leukemia Relapse, Meghan G. Haney

Theses and Dissertations--Molecular and Cellular Biochemistry

The survival rate of T-cell Acute Lymphoblastic Leukemia (T-ALL) relapse is a dismal 10% of affected adults and 30% of children, largely due to the relapsed disease being more aggressive and treatment resistant than the initial disease. Relapse is thought to occur because conventional chemotherapies are unable to reliably eliminate a unique cell type known as leukemia stem (or propagating) cells (LSCs). LSCs are the only cells within the leukemia with the ability to self-renew and remake or replenish the ALL from a single cell. Currently, the pathways governing self-renewal in LSCs are largely unknown, precluding our ability to successfully …

Reversible Glucan Phosphorylation In The Red Alga, Cyanidioschyzon Merolae, Corey Owen Brizzee

Theses and Dissertations--Molecular and Cellular Biochemistry

Starch and glycogen are an essential component for the majority of species and have been developed to maintain homeostasis in response to environmental changes. Water-soluble glycogen is an excellent source of quick, short-term energy in response to energy demands. In contrast, plants and algae have developed the macromolecule starch that is elegantly suitable for their dependence on external circumstances. Semi-crystalline starch is water-insoluble and inaccessible to most amylolytic enzymes, thus plants and algae have developed a coordinated system so that these enzymes can gain access to the denser starch energy cache. Starch-like semi-crystalline polysaccharides are also found in red algae, …

Examination Of Sex- And Intensity-Specific Fatigue During Bilateral Leg Extension Exercise, Taylor Kayln Dinyer

Theses and Dissertations--Kinesiology and Health Promotion

The purposes of this study were to: 1) examine sex-related differences in the performance of repetitions to failure below (CL_-10%, CL_-20%) and above (50%, 60%, 70%, and 80% 1RM) the critical load (CL) to make inferences regarding the mechanisms responsible for variability in the performance of repetitions to failure at varying loads; 2) examine the time course of neuromuscular and muscle oxygen saturation responses during the performance of repetitions to failure below and above the CL; 3) to make inferences regarding motor unit activation strategies used to maintain force during the completion of repetitions below and …

Characterization Of Spontaneous Preeclampsia In The African Green Monkey (Chlorocebus Aethiops Sabaeus), Chelsea Christina Weaver

Theses and Dissertations--Biology

Hypertensive pregnancy disorders are a major contribution to maternal and neonatal mortality worldwide. Two of these disorders, preeclampsia and chronic hypertension in pregnancy, affect up to 10% of all pregnancies. These hypertensive disorders of pregnancy are associated with long-term, postnatal risk factors for both mother and offspring. Despite numerous recent advances in preeclampsia research, the underlying mechanisms are still not understood. This could be due to lack of a spontaneous animal model. This dissertation presents the African Green Monkey (AGM; Chlorocebus aethiops sabaeus) as the first known spontaneous animal model of preeclampsia and a highly translational model of chronic …

Cellular Bioenergetics Regulates Cell Proliferation During Mammalian Regeneration, Sandeep Saxena

Theses and Dissertations--Biology

Mammalian system consists of stress-sensing molecules that regulates their cellular response against damage, injury and oncogenic stress. During vertebrate regeneration, cells responding to injury re-enter the cell cycle and proliferate to form new tissue. Cell cycle re-entry or arrest is at least partly regulated by cellular senescence which negatively impacts the proliferative pool of cells during regeneration. What remains unclear is whether cells in regenerating systems possess an increased propensity to proliferate and are refractory to signals that induce senescence. My thesis work has focused on how fibroblasts from the ear pinna differentially regulate healing in highly regenerative mammals (e.g., …

Cloning And Functional Characterizations Of Circular Rnas From The Human Mapt Locus, Justin R. Welden

Theses and Dissertations--Molecular and Cellular Biochemistry

Under pathophysiological conditions, the microtubule protein tau (MAPT) forms neurofibrillary tangles that are the hallmark of sporadic Alzheimer’s disease as well as familial frontotemporal dementias linked to chromosome 17 (FTDP-17). In this work, I report that MAPT forms circular RNAs through backsplicing of exon 12 to either exon 10 or exon 7 (12→10; 12→7), and that these circular RNAs are translated into proteins.

Using stable cell lines overexpressing the circular tau RNAs 12→7 and 12→10, we have discovered that the tau circular RNA 12→7 is translated in a rolling circle, giving rise to multiple proteins. This circular RNA …

Pre-Clinical Advancements In Biomarkers, Tools, And Therapeutics For A Metabolic Neurodegenerative Disease, Zoë Simmons

Theses and Dissertations--Molecular and Cellular Biochemistry

Glycogen is the storage form of glucose and a highly important substrate for cellular metabolism. Characterization of the enzymes and mechanisms of glycogen metabolism began over 70 years ago and over the last 20 years, a previously unknown protein called laforin has emerged as an important contributor to glycogen metabolism homeostasis. Multiple labs demonstrated that laforin is a glycogen phosphatase and mutations in the gene encoding laforin cause the formation of aberrant glycogen-like aggregates called Lafora bodies (LBs). LBs are cytoplasmic, water-insoluble aggregates that drive neurodegeneration and early death in Lafora disease (LD) patients. The direct relationship between mutated laforin, …