Medicine and Health Sciences Commons^™

Nhe1 And Tau Pathology: Tragically Tangled Together?, Caitlin Rae Wessel

Lewis Honors College Capstone Collection

Alzheimer’s Disease (AD) is an age-related neurodegenerative disease that poses a large public health challenge due to its complex, mixed pathology. One hallmark characteristic of AD is the development of toxic neurofibrillary tau tangles (NFT), which have been associated with the neurodegenerative component of AD. There is also compelling evidence that cerebrovascular disease puts individuals at a greater risk for experiencing the cognitive decline characteristic of dementias like AD. Past research has shown that individuals suffering from cerebrovascular disease and AD (not necessarily simultaneously) display an increased expression of the sodium-hydrogen antiporter-1 (NHE1), a plasma membrane protein ubiquitously expressed throughout …

Application Of High Performance Training Strategies To Enhance Occupational Readiness In Law Enforcement Cadets, Gabriel Jose Martinez

Theses and Dissertations--Kinesiology and Health Promotion

Law enforcement requires cadets to achieve a requisite level of physical fitness to prepare for occupational demands. However, there is limited research on the effectiveness of academy exercise programs to optimize physical fitness and occupational physical ability through high performance training strategies more typically utilized in elite athletic populations. Furthermore, there is a paucity of research identifying physical fitness correlates of occupational performance. Collectively, this information will provide academies and practitioners with critical information to develop evidence-based training programs. Therefore, the purposes of this study were to: Aim 1) Examine the effectiveness of integrating autoregulatory progressive resistance exercise (APRE) and …

Synthesis And Characterization Of Tripodal-Imidazolium And Pyridazine Ruthenium Complexes And Their Associated Ligands, Jacqueline L. Kowalke

Lewis Honors College Capstone Collection

Photochemical therapy (PCT) is a relatively new treatment for cancer. PCT, unlike photodynamic therapy (PDT), does not require oxygen though it may be one of the mechanisms that the photosensitizer uses to destroy cancerous cells. Ruthenium complexes have recently entered clinical trials for the treatment of cancer. TLD1433, a ruthenium coordination complex, has entered phase II clinical trials for the treatment of non-muscular invasive bladder cancer. In this compound, the ligands are coordinated via nitrogen bonds, but in this paper, carbon-coordinated complexes are explored. Coordination of N-heterocyclic carbene (NHC) ligands to ruthenium is suspected to provide a different type of …

Multi-Modal Medical Imaging Analysis With Modern Neural Networks, Gongbo Liang

Theses and Dissertations--Computer Science

Medical imaging is an important non-invasive tool for diagnostic and treatment purposes in medical practice. However, interpreting medical images is a time consuming and challenging task. Computer-aided diagnosis (CAD) tools have been used in clinical practice to assist medical practitioners in medical imaging analysis since the 1990s. Most of the current generation of CADs are built on conventional computer vision techniques, such as manually defined feature descriptors. Deep convolutional neural networks (CNNs) provide robust end-to-end methods that can automatically learn feature representations. CNNs are a promising building block of next-generation CADs. However, applying CNNs to medical imaging analysis tasks is …

Development Of A Robust Treatment Delivery Framework For Stereotactic Body Radiotherapy (Sbrt) Of Synchronous Multiple Lung Lesions, Lana Catherine Critchfield

Theses and Dissertations--Radiation Medicine

Stereotactic body radiation therapy (SBRT) of lung tumors uses high doses of radiation to deliver high biological effective doses (BED) in very few fractions (1-5). With the use of highly conformal fields to cover the tumor without depositing large doses to non-cancerous structures, this technique has proven time and again to be successful at achieving high local control. However, frequently patients receiving SBRT are elderly with multiple medical comorbidities who may not tolerate long treatment times. Furthermore, many patients present with oligometastatic or multiple primary lung tumors. The success of SBRT on oligometastatic lung disease relies on physician experience with …

Will "Social Distancing" Lead To Future "Research Distancing": A Reflection On Covid-19 Impacts On Alzheimer's Disease Research, Shoshana H. Bardach, Allison K. Gibson, Elizabeth K. Rhodus, Gregory A. Jicha

Sanders-Brown Center on Aging Faculty Publications

Coronavirus disease 19 (COVID-19) has dramatically altered everyday life, including the field of Alzheimer's disease (AD) research. This perspective article explores some of the ways in which COVID-19 has already impacted the field, anticipates some of the long-lasting effects, and explores strategies for addressing current and future needs. Areas of impact include study integrity, regulatory and industry issues, and participant engagement. Proposed strategies for addressing these challenges include analytic methods to deal with large degrees of missing data and development of patient-centered, user-friendly, remote data collection tools and assessments. We also highlight the importance of maintaining participant well-being as a …

Opioid And Non-Opioid Prescribing Rates For Ankle Fractures In Emergency Departments Across The United States Between 2006 And 2015, Lucy C. Bowers, Kyle B. Kosik, Alejandro G. Villasante Tezanos, Matthew C. Hoch, Phillip A. Gribble

Posters-at-the-Capitol Presentations

This presentation describes the percentage of patients prescribed a controlled and non-controlled medication in an United States Emergency Department for a diagnosed ankle fracture.

Time Spent Exercising And Obesity: An Application Of Lewbel’S Instrumental Variables Method, Charles J. Courtemanche, Joshua C. Pinkston, Jay Stewart

Institute for the Study of Free Enterprise Working Papers

This paper examines the role physical activity plays in determining body mass using data from the American Time Use Survey. Our work is the first to address the measurement error that arises when time use during a single day—rather than average daily time use over an extended period—is used as an explanatory variable. We show that failing to account for day-to-day variation in activities results in the effects of time use on a typical day being understated. Furthermore, we account for the possibility that physical activity and body mass are jointly determined by implementing Lewbel’s instrumental variables estimator that exploits …

Clinical Signs Associated With A Case Of Iatrogenic Poisoning By A Turpentine-Based Commercial Product In A 3-Day-Old Foal, Abelardo Morales Briceño, Hilal Al Mahrouqi, Abdallah Al Kayyoomi, Harmon Oliva, Kimberly Brewer, Thomas Tobin

Maxwell H. Gluck Equine Research Center Faculty Publications

The aim of this study is to report a case of iatrogenic poisoning by a turpentine-based commercial product in a 3-day-old foal and the successful treatment of this condition. A 3-day-old male foal presented with acute cardio-respiratory collapse, anaphylactic shock, severe respiratory distress, dyspnea and pulmonary edema. The animal’s history included previous administration of a commercial veterinary product (UNITIPAN). Clinical examination revealed: temperature: (39.9 °C), pulse: 135 bpm, respiration: 51 bpm, mucous membranes: moist and congested, capillary refill time: 3 sec or less. The foal was treated with emergency hydration, duphalyte, steroidal anti-inflammatory, atropine sulphate and antibiotic. After 6 h …

2019 Kentucky Board Of Nursing Workforce Update, Sydney P. Thompson, Frances J. Feltner, Melissa A. Slone

Center of Excellence in Rural Health Infographics

No abstract provided.

Kentucky’S Primary Care Workforce: Current Status And Output Of New Trainees January 2020 Update, Kevin A. Pearce, Sydney P. Thompson, Frances J. Feltner

Center of Excellence in Rural Health Workforce Reports

Primary care is the backbone of American healthcare. Primary care (PC) physicians are especially cost-effective in preventing and managing illness and disability, and prolonging years of quality life. They also contribute significantly to the economy of their communities. Primary care shortages across the Commonwealth are severe. Kentucky ranks 43^rd in the USA for its number of PC physicians per 100,000 people. The Commonwealth would have to add 246 primary care physicians annually to reach the US median by the end of 2029. Kentucky produces and retains only about 55 new PC physicians per year, recruiting 55 to 60 more …

Early Acid/Base And Electrolyte Changes In Permanent Middle Cerebral Artery Occlusion: Aged Male And Female Rats, Sarah R. Martha, Lisa A. Collier, Stephanie M. Davis, Sarah J. Goodwin, David Powell, Doug Lukins, Justin F. Fraser, Keith R. Pennypacker

Neurosurgery Faculty Publications

BACKGROUND: Early changes in acid/base and electrolyte concentrations could provide insights into the development of neuropathology at the onset of stroke. We evaluated associations between acid/base and electrolyte concentrations, and outcomes in permanent middle cerebral artery occlusion (pMCAO) model.

METHODS: 18-month-old male and female Sprague-Dawley rats underwent pMCAO. Pre-, post- (7 min after occlusion), and at 72 hr of pMCAO venous blood samples provided pH, carbon dioxide, oxygen, glucose, hematocrit, hemoglobin, and electrolyte values of ionized calcium, potassium, and sodium. Multiple linear regression determined predictors of infarct and edema volumes from these values, Kaplan-Meier curve analyzed morality between males and …

Communication Of Professional Readiness In Dietetics And Human Nutrition Undergraduates: A Pilot Study, Heather Norman-Burgdolf, Emily M. Dewitt, Nathan L. Vanderford, Julie Plasencia

Dietetics and Human Nutrition Faculty Publications

Learning experiences within the dietetics and human nutrition undergraduate curricula develop knowledge and skills pertinent to student career goals. Core competency requirements are extensively assessed in these programs, yet the communication of transferable skills gained and student professional readiness are rarely examined. The purpose of this study was to evaluate undergraduate students' perceived professional readiness following six professional development workshops on transferable skills and career preparedness communicated through resumes and personal statements. In this pilot study, twelve upper-level dietetics and human nutrition students self-assessed their resumes and personal statements with rubrics and completed surveys before and after the intervention. Following …

Boundaries And Infomediaries: A Qualitative Study Of The Information Practices Of Community Health Workers, Robert M. Shapiro Ii

Theses and Dissertations--Communication

Despite successful efforts to treat and manage diseases, public health officials have recently begun a campaign to refocus efforts toward initiatives to alleviate the pressures that are often referred to as social determinants of health. In eastern Kentucky, and in other geographical regions labeled as health professional shortage areas or medically underserved areas, issues stemming from social determinants are compounded with health care systems that are often lacking the human resources to meet basic medical needs. One strategy has been to utilize volunteers and paraprofessionals such as community health workers to lessen the burden on the primary care and hospital …

Analysis Of Information Value Chains For Gout Self-Care Management, Maranda Russell

Theses and Dissertations--Communication

This value chain analysis study sought to identify information needed by gout patients to successfully manage their disease, leading to a model for information extraction from patient health records. A scoping review was conducted to identify the types of information needed by gout patients. The findings of each included study were divided and analyzed according to the stages of the care delivery value chain. The results of the review were then used to create a gout information value chain as criteria for annotating the information deemed important for gout patients contained in publicly available patient education materials according to the …

Occupational Opioid Surveillance And Intervention Evaluation: A Mixed Methods Collaborative Project Among Southeast First Responders, Robin Thompson

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

Introduction: This capstone assessed and addressed the issue of occupational opioid exposure among first responders working in the southeastern United States from 2017-2019. The first study aimed to assess the emerging issue of occupational opioid exposure as well as current knowledge and training practices among first responders of the following southeastern states: Kentucky, Georgia, Mississippi, and Virginia. The second study aimed to address this emerging issue through formative research followed by evaluation of the impact of an educational video and associated knowledge gained with a group of Kentucky-based first responders.

Methods: The analysis drew from three primary datasets: (1) self-reported …

Aging Induces B Cell Defects And Decreased Antibody Responses To Influenza Infection And Vaccination, Daniela Frasca, Bonnie B. Blomberg

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Background: Aging is characterized by a progressive decline in the capacity of the immune system to fight influenza virus infection and to respond to vaccination. Among the several factors involved, in addition to increased frailty and high-risk conditions, the age-associated decrease in cellular and humoral immune responses plays a relevant role. This is in large part due to inflammaging, the chronic low-grade inflammatory status of the elderly, associated with intrinsic inflammation of the immune cells and decreased immune function.

Results: Aging is usually associated with reduced influenza virus-specific and influenza vaccine-specific antibody responses but some elderly individuals with higher pre-exposure …

Ethanol Induced Neurotoxicity Through Dysregulation Of Ampk In A Fetal Alcohol Syndrome Model, Jessica Gebhardt

Theses and Dissertations--Medical Sciences

Ethanol consumption during pregnancy is rising in the U.S., including the rate of binge drinking. It is reported around 1 in 27 women engage in binge drinking activities while pregnant. The third trimester is a sensitive period of neuronal growth in which ethanol induced neurotoxicity can cause many harmful effects including Fetal Alcohol Spectrum Disorders. It has been shown that ethanol decreases the activity of AMPK through increasing lipid peroxidation, both of which are correlated to neurotoxicity. AICAR is a synthetic analog of AMP which significantly increases AMPK activity and may have beneficial effects in an organotypic hippocampal model of …

Experiences Of Adolescents In The General Education Setting Interacting With Peers With Intellectual Disability, Katie Goldey

Theses and Dissertations--Rehabilitation Sciences

Social interaction is critical to health, quality of life, and linguistic and cognitive development. However, young people with intellectual disabilities are unlikely to have equitable opportunities for social interaction. This may be particularly true of adolescents. This study used qualitative phenomenological methods to examine the lived experiences of students in the general education setting interacting with their peers with intellectual disability. Twenty participants engaged in one on one interviews with the author. Interviews were recorded, transcribed verbatim, and analyzed for overarching themes. Four main themes emerged from the data including: (1) Teens just don’t have many opportunities to interact with …

Examining Cultural Influences On Dietary Behaviors Among Mexican Americans With Low Acculturation, Austyn Erickson

Theses and Dissertations--Nutrition and Food Systems

Mexican Americans represent approximately 63 percent of the total Hispanic population in the US and are disproportionately affected by health disparities related to poor nutrition status. With this community among the fastest growing populations in the US, it is critical to address the health disparities and the relationship between culture and diet to provide evidence-based nutrition interventions that are culturally sensitive to specific communities. The purpose of this cross-sectional exploratory study is to examine the relationship between cultural values and dietary behaviors among a low-income, urban, clinical sample of Mexican Americans using the Mexican American Cultural Values Scale, dietary assessment, …

Evaluation Of Efficacy And Safety Of Adult Diabetic Ketoacidosis (Dka) Treatment Protocol At A Tertiary Health Care Center, Kristina Chereshnieva

DNP Projects

BACKGROUND: Hypoglycemia can be a complication of diabetic ketoacidosis (DKA) protocols. This prolongs time to DKA resolution, increasing hospital stay and mortality risk. Does a revised DKA protocol reduce the incidence of hypoglycemia and reopening of the anion gap due to inappropriate transition to subcutaneous insulin? There is a lack of published data in the U.S. on factors affecting time to resolution of DKA and LOS in the ICU. This review was focused on evaluation of safety outcomes and protocol effectiveness by comparing hypoglycemia and hypokalemia events and instances of anion gap reopening for the duration of DKA treatment. …

Examining The Role Of Metabolic Pathways As Therapeutic Modalities For Triple Negative Breast Cancer, Jeremy Andrew Johnson

Theses and Dissertations--Toxicology and Cancer Biology

Triple negative breast cancer (TNBC) comprises 15-20% of breast cancers, affects a younger patient population than other subtypes, and is very aggressive. TNBC is comprised of a diverse group of tumors that have proven refractory to targeted therapy and can be difficult to treat. Patients generally receive neoadjuvant chemotherapy (NAC), surgery, and radiotherapy. The standard of care for NAC includes a taxane, an anthracycline, and/or cyclophosphamide, and administration of NAC has resulted in pathological complete response (pCR) in 30-40% of patients. However, a majority of TNBC patients will not reach pCR and instead have residual disease (RD), which is associated …

Syringe Exchange Programs And Emergency Department Use For Drug Overdoses In Kentucky, Timothy Williams

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

In 2015, syringe exchange programs (SEPs) were legalized in Kentucky as part of a response to the high and rising morbidity and mortality associated with injection drug use, particularly opioids. In addition to their primary function of preventing the spread of some infectious diseases by providing injection drug users (IDUs) with easy access to sterile injection equipment, SEPs may also offer ancillary services such as referrals to primary care providers and substance abuse and mental health treatment, as well as safe injection education and naloxone training. These ancillary services are intended to improve the overall health of IDUs and the …

A Rapid Review Of Physician Burden Secondary To Electronic Health Records Use In The United States From 2015 To 2020, Lori Wong

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

Background: After the passing of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, there has been a tremendous increase in the number of hospitals and providers adopting and using Electronic Health Records (EHRs). While EHRs were a way of improving efficiency, quality, and safety of healthcare, there is emerging evidence that they are contributing to physician burden, which can take the form of increased workload, decreased satisfaction, negative attitudes, and burnout. For instance, Arndt et al. found that physicians spent half of their workday on the EHR during and after work, and Robertson et al. …

Hospital-Based Safe To Sleep Intervention To Decrease Sleep-Related Infant Deaths In St. Louis, Missouri, Olivia M. Pokoski

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

The city of St. Louis in Missouri has an elevated infant mortality rate compared to St. Louis County, Missouri, and the United States. When controlling for race, black or African American infants are over twice as likely to die before their first birthday compared to their white counterparts. Two of the leading causes of infant death are sleep-related causes and sudden infant death syndrome (SIDS) which occur if the infant is placed in an unsafe sleeping environment. To address this burden Affinia Healthcare, Barnes Jewish Hospital, and St. Mary’s Hospital have decided to implement a hospital-based Safe to Sleep campaign. …

Growing Green Minds: Implementation Of A School Garden & Nutrition Program For The Freedom Area School District In Rural Wisconsin, Marissa Schuh

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

Most children in the U.S. consume too few fruits and vegetables which is putting them at risk to develop obesity and other lifestyle diseases. The 2015-2020 Dietary Guidelines for Americans recommends that individuals should increase the amount and variety of fruits and vegetables consumed in order to prevent weight gain and other chronic diseases. Research shows that garden-based educational programs can increase children’s fruit and vegetable intake as well as change their preferences and attitudes towards eating and trying new fruits and vegetables. Incorporating a garden and nutrition curriculum into a school setting is an ideal opportunity to improve children’s …

Implementing The Fit And Strong! Program To Reduce Osteoarthritis In The Older Adult Population Of Carmel, Indiana, Lauren Alexis Bergstrom Roach

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

Osteoarthritis is a health outcome most commonly experienced by older adults. As the “baby boomer” population continues to age, the demand for services for older adults also increases. Fit and Strong! is an evidence-based program that works to reduce symptoms of osteoarthritis in this population through an 8-week course of physical activity classes, taught by Fit and Strong! certified instructors. Carmel, Indiana, a city in Hamilton County, has a high percentage of older adults within its population, and community health needs assessments have indicated that Hamilton County citizens have repeatedly expressed a need for resources for older members of the …

Clinical And Neurophysiological Effects Of Dry Needling On Individuals With Chronic Ankle Instability, Jennifer Mullins

Theses and Dissertations--Rehabilitation Sciences

Ankle sprains are generally considered innocuous injuries; however, as many as 74% of patients will develop chronic symptoms. 1-3 Chronic ankle instability (CAI) is defined by a history of ankle sprain accompanied by ongoing bouts of giving way, residual ankle sprain symptoms, and a decrease in patient-perceived function. As understanding of sensorimotor deficits in individuals with CAI have advanced, treatment strategies have evolved to include a robust focus on balance training to mitigate dynamic and static postural control impairments exhibited in individuals with CAI. A problem arises as these improvements have not been conclusively linked to a decrease in CAI. …

The Effects Of Three Service Delivery Models On Vocabulary Learning By Second-Grade Children, Laura Stone

Theses and Dissertations--Rehabilitation Sciences

Speech-Language Pathologists (SLPs) provide services to children in schools across the United States primarily in a direct small group service delivery model outside of the regular education classroom. To date little research exists to indicate that direct pull-out service delivery is an effective model in elementary schools for students requiring speech and language therapy. One area that has been studied is the effectiveness of vocabulary intervention among service delivery models. Preliminary findings suggest that students with language and literacy deficits learn vocabulary well within a regular education environment with SLP support. However, there is little consensus on how service delivery …

Effects Of Load Carriage On Shoulder Neuromuscular Functions And Recovery, Muataz R. Almaddah

Theses and Dissertations--Rehabilitation Sciences

Load carriage is a primary source for injury occurrence among military personnel and recreational hikers affecting all body areas. The shoulder ranks as the second or third most common site of injuries among military personnel. Many studies report that elevations in self-reported fatigue, soreness, and discomfort in the shoulders accompany the load carriage. Almost 50% of military personnel experienced a load carriage injury during the first episode of training, and 75% of those injured suffered a second injury during their career. The goal of this research project is to investigate the components associated with load carriage shoulder symptoms to determine …