Medicine and Health Sciences Commons^™

The Need For Certified Diabetes Educators And Community Health Workers In Community-Based Diabetes Self-Management Education For High Risk Groups, Frances J. Feltner, Sydney P. Thompson, Melissa Slone

Center of Excellence in Rural Health Workforce Reports

The number of Americans with diabetes is projected to double, or triple by 2050 according to the Center for Disease Control (CDC). The CDC reports that as many as 1 in 3 U.S. adults could have diabetes by 2050, currently 1 in 10 U.S. adults has diabetes. Longer lifespans and an older, more diverse population are consider contributing factors for the current trend. Research shows that in spite of prevention efforts and medical advances, the prevalence of diabetes will increase by 54% between 2015 and 2030; annual deaths attributed to diabetes will climb by 38%; and total annual medical and …

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

Philosophy Faculty Publications

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

Functional Characterization Of Scaffold Protein Shoc2, Hyein Jang

Theses and Dissertations--Molecular and Cellular Biochemistry

Signaling scaffolds are critical for the correct spatial organization of enzymes within the ERK1/2 signaling pathway and proper transmission of intracellular information. However, mechanisms that control molecular dynamics within scaffolding complexes, as well as biological activities regulated by the specific assemblies, remain unclear.

The scaffold protein Shoc2 is critical for transmission of the ERK1/2 pathway signals. Shoc2 accelerates ERK1/2 signaling by integrating Ras and RAF-1 enzymes into a multi-protein complex. Germ-line mutations in shoc2 cause Noonan-like RASopathy, a disorder with a wide spectrum of developmental deficiencies. However, the physiological role of Shoc2, the nature of ERK1/2 signals transduced through this …

Examination Of Resistance Settings Based On Body Weight For The 3-Minute All-Out Critical Power Test, Marlene J. Schulte, Jody L. Clasey, Bradley S. Fleenor, Haley C. Bergstrom

Kinesiology and Health Promotion Faculty Publications

There are conflicting suggestions regarding the most valid resistance (3-5% of body weight) to use for the critical power (CP) 3-min all-out (CP_3min) test to estimate CP and anaerobic work capacity (AWC). The purpose of this study was to determine if the CP and AWC estimates from the CP_3min test were affected by the percentage of body weight used to set the resistance on a Monark cycle ergometer. Ten recreationally trained participants (mean ± SD: Age: 22.2 ± 2.2 yrs.) completed the CP_3min test at resistances of 4.5% (CP_4.5%) and 3% (CP_3%) …

Effects Of Very Short-Term Dynamic Constant External Resistance Exercise On Strength And Barbell Velocity In Untrained Individuals, M. Travis Byrd, Haley C. Bergstrom

Kinesiology and Health Promotion Faculty Publications

This study examined the effect of an upper body dynamic constant external resistance (DCER) exercise (barbell bench press [BP]), using the very short-term training (VST) model on strength and barbell velocity. Ten (5 females, 5 males) subjects (mean ± SD age: 21.4 ± 2.8 yrs; height: 1.75 ± 0.12 m; body mass: 83 ± 8.8 kg) completed two pre-test visits (pre-test 1 and pre-test 2) to serve as the within subjects control, three training visits, and one post-test visit. The subject’s 1 repetition maximum (1RM) for the BP as well as the mean (BP_MV) and peak (BP_{PV …}

Defining The Health Of A Work Environment: An Assessment And Evaluation, Jennifer Thornsberry

DNP Projects

PURPOSE: The purpose of this study was to ascertain nursing leaders and direct care nurses’ perceptions of the health of the work environment in medical-surgical, intermediate care, and progressive care units at an acute care hospital located in central Kentucky. METHODS: This study employed a descriptive, correlational design. Bivariate statistical procedures were utilized to determine the relationship between the perceptions of the health of the work environment and nursing turnover and engagement. RESULTS: Direct care nurses and nurse leaders both scored effective decision making/skilled communication as the healthiest attribute of the work environment, while genuine teamwork was scored as the …

Perceived Treatment Need And Utilization For Illicit Drug And Opioid Use Disorders In Non-Metropolitan Areas, Tyrone F. Borders, Hefei Wen

Rural & Underserved Health Research Center Publications

The policy brief provides nationally representative estimates of perceived treatment need and utilization for illicit drug and prescription pain reliever use disorders among non-metropolitan and metropolitan adults ages 18-64.

Illicit Drug And Opioid Use Disorders Among Non-Metropolitan Residents, Tyrone F. Borders, Hefei Wen

Rural & Underserved Health Research Center Publications

Illicit drug use disorder rates are similar across metropolitan and non-metropolitan areas and did not decline from 2011-2013 to 2014-2015 despite the implementation of major substance use treatment policies over this time period.

Evaluation Of Self-Efficacy And Confidence Levels Among Newly Graduated Nurses Exposed To An End-Of-Life Simulation: A Comparison Study, Catherine Edwards

DNP Projects

Purpose: The purpose of this project is to compare self-efficacy and confidence levels among a cohort of newly graduated nurses (defined as nurses who have had no nursing experience and are participating in a new graduate nursing residency) who will participate in an EOL simulation with another cohort of nurses who have been practicing for a year or more, but have not participated in an end-of-life simulation.

Methods: The study included two parts. The first portion included a pre and post-test evaluation of an end-of-life (EOL) simulation intervention with newly graduated nurses (Group One, n= 22), as part of their …

Uk Cerh Social Work Programs: History & Employment Outlook, Jessica Williamson, Dana Hays, Melissa Slone, Frances J. Feltner

Center of Excellence in Rural Health Workforce Reports

The University of Kentucky (UK) began to offer off-campus programs to the Commonwealth in 1975 under Ronda Connaway, the second dean of the College of Social Professions (COSP)—which became the College of Social Work (COSW) in 1980 (UK COSW, 2016). Dean Connaway’s vision was to expand the program to provide advance-degreed social workers based on student, employer and community demand (College History, 2016).

Medical Laboratory Science Workforce Shortage, Michelle Butina, Frances J. Feltner, Melissa Slone

Center of Excellence in Rural Health Workforce Reports

Prior to 1900, laboratory tests were rudimentary, few in number, and often performed by a physician in his office or by a pathologist in hospitals. Epidemic outbreaks of diphtheria, pneumonia, typhoid, and tuberculosis created a demand for additional laboratory tests and individuals to perform them. The increase in civilian and military clinical (hospital) laboratories during World War I and the new American College of Surgeons requirement that hospitals establish a clinical laboratory contributed to a severe shortage of laboratory personnel (Kotlarz, 1998a).

Ictv Virus Taxonomy Profile: Chrysoviridae, Said A. Ghabrial, José R. Castón, Robert H. A. Coutts, Bradley I. Hillman, Daohong Jiang, Dae-Hyun Kim, Hiromitsu Moriyama, Ictv Report Consortium

Plant Pathology Faculty Publications

The Chrysoviridae is a family of small, isometric, non-enveloped viruses (40 nm in diameter) with segmented dsRNA genomes (typically four segments). The genome segments are individually encapsidated and together comprise 11.5–12.8 kbp. The single genus Chrysovirus includes nine species. Chrysoviruses lack an extracellular phase to their life cycle; they are transmitted via intracellular routes within an individual during hyphal growth, in asexual or sexual spores, or between individuals via hyphal anastomosis. There are no known natural vectors for chrysoviruses. This is a summary of the International Committee on Taxonomy of Viruses (ICTV) Report on the taxonomy of the Chrysoviridae, which …

Ictv Virus Taxonomy Profile: Partitiviridae, Eeva J. Vainio, Sotaro Chiba, Said A. Ghabrial, Edgar Maiss, Marilyn Roossinck, Sead Sabanadzovic, Nobuhiro Suzuki, Jiatao Xie, Max Nibert, Ictv Report Consortium

Plant Pathology Faculty Publications

The Partitiviridae is a family of small, isometric, non-enveloped viruses with bisegmented double-stranded (ds) RNA genomes of 3–4.8 kbp. The two genome segments are individually encapsidated. The family has five genera, with characteristic hosts for members of each genus: either plants or fungi for genera Alphapartitivirus and Betapartitivirus, fungi for genus Gammapartitivirus, plants for genus Deltapartitivirus and protozoa for genus Cryspovirus. Partitiviruses are transmitted intracellularly via seeds (plants), oocysts (protozoa) or hyphal anastomosis, cell division and sporogenesis (fungi); there are no known natural vectors. This is a summary of the International Committee on Taxonomy of Viruses (ICTV) …

Objectively Measuring Effects Of Electro-Acupuncture In Parkinsonian Rhesus Monkeys, Rui Zhang, Anders H. Andersen, Peter A. Hardy, Eric Forman, April Evans, Yi Ai, Jin Yue, Guihua Yue, Don M. Gash, Richard Grondin, Zhiming Zhang

Magnetic Resonance Imaging and Spectroscopy Center Faculty Publications

Acupuncture has increasingly been used as an alternative therapy for treatment of Parkinson’s disease (PD). However, the efficacy of acupunture for PD still remains unclear. The present study was designed to objectively and safely monitor anti-parkinsonian effects of electroacupuncture (EA) and brain activity in nonhuman primates modeling human PD. Six middle-aged rhesus monkeys were extensively studied by a computerized behavioral testing battery and by pharmacological MRI (phMRI) scans with specific dopaminergic drug stimulations. All animals were evaluated for behavior and phMRI responses under normal, parkinsonian, parkinsonian with EA treatment and parkinsonian after EA treatment conditions. Stable parkinsonian features were observed …

Cgas Drives Noncanonical-Inflammasome Activation In Age-Related Macular Degeneration, Nagaraj Kerur, Shinichi Fukuda, Daipayan Banerjee, Younghee Kim, Dongxu Fu, Ivana Apicella, Akhil Varshney, Reo Yasuma, Benjamin J. Fowler, Elmira Baghdasaryan, Kenneth M. Marion, Xiwen Huang, Tetsuhiro Yasuma, Yoshio Hirano, Vlad Serbulea, Meenakshi Ambati, Vidya L. Ambati, Yuji Kajiwara, Kameshwari Ambati, Shuichiro Hirahara, Ana Bastos-Carvalho, Yuichiro Ogura, Hiroko Terasaki, Tetsuro Oshika, Kyung Bo Kim, David R. Hinton, Norbert Leitinger, John C. Cambier, Joseph D. Buxbaum, M. Cristina Kenney, Bradley D. Gelfand, Jayakrishna Ambati

Ophthalmology and Visual Science Faculty Publications

Geographic atrophy is a blinding form of age-related macular degeneration characterized by retinal pigmented epithelium (RPE) death; the RPE also exhibits DICER1 deficiency, resultant accumulation of endogenous Alu-retroelement RNA, and NLRP3-inflammasome activation. How the inflammasome is activated in this untreatable disease is largely unknown. Here we demonstrate that RPE degeneration in human-cell-culture and mouse models is driven by a noncanonical-inflammasome pathway that activates caspase-4 (caspase-11 in mice) and caspase-1, and requires cyclic GMP-AMP synthase (cGAS)-dependent interferon-β production and gasdermin D-dependent interleukin-18 secretion. Decreased DICER1 levels or Alu-RNA accumulation triggers cytosolic escape of mitochondrial DNA, which engages cGAS. Moreover, caspase-4, gasdermin …

Mindfulness And Multiple Sclerosis, Mandakini Sadhir

Pediatrics Faculty Publications

Multiple sclerosis is a chronic, debilitating autoimmune condition with unknown etiology. It can have significant impact on quality of life and overall sense of wellbeing. It can be associated with poor sleep, fatigue, mental health disorders such as anxiety, depression and affect interpersonal relationships. Impact of mindfulness based interventions in mental health conditions, chronic illness as well as multiple sclerosis in adults has been widely studied. Several studies have concluded that mindfulness based intervention can be beneficial in improving quality of life, mental health and physical symptoms such as fatigue in adult patients with multiple sclerosis. Current literature suggest that …

Quitting Together: Formative Research To Develop A Social Marketing Plan For Smoking Cessation Among Women In A Residential Treatment Facility For Substance Abuse Recovery, August D. Anderson

Theses and Dissertations--Communication

Both smoking addiction and illicit substance abuse are prevalent issues in the United States today. Furthermore, these are issues that have significant impact on women’s health and mental state. Despite research that shows that smoking cessation coupled with substance abuse recovery can decrease likelihood of relapse post-recovery, few substance abuse recovery facilities today offer smoking cessation programming options. To address the issue of smoking addiction on top of substance abuse recovery, formative research was conducted through this study to determine the underlying causes of smoking habits coupled with recovery efforts and the attitudes. Through focus group sessions with women in …

Aps’Aalooke Led Diabetes Prevention Program, Lucy Hollingsworth Williamson

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

The primary objective of this proposed program is to decrease the burden of diabetes mellitus type II among the Crow Indian tribe members in Montana by preventing the progression of prediabetes to diabetes. Type II diabetes mellitus (DMII), is a debilitating disease that contributes to increased morbidity and mortality, in addition to billions of healthcare costs annually. In the United States, minority populations carry a higher burden of DMII, however American Indians have the highest prevalence of all. In fact, American Indians are 2.4 times more likely to be diagnosed with diabetes than white people.

In Montana, the Crow Indian …

Consultation Experience In Public Health, Xiangya Meng

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

This capstone project describes the results of a consultative experience in biostatistics.

Evaluation Of A Pharmacist Led Medication Reconciliation Process In Primary Care, Benjamin T. Gatlin

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

Medication safety should be at the forefront of public health initiatives. Medication reconciliations in primary care are key to successful, accurate, and safe medication use. Pharmacists are well positioned and educated to have an impact on medication safety by conducting reconciliations in primary care centers. Guidelines for training pharmacists on how to conduct medication reconciliations would be a useful tool for any health board striving to improve medication safety. This study uses observations from pharmacists currently conducting medication reconciliations in primary care to propose such guidelines in the form of a flow sheet. The resulting flow sheet and observations are …

Predictors Of Pm 2.5 And Radon Concentrations In Residences Of Central Kentucky: A Cross Sectional Study, Kyle T. Hancock

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

Aim: To measure levels of respirable particles (PM 2.5) and radon in homes in Central Kentucky and assess modifiable risk factors that could reduce the morbidity and mortality of cardiovascular and respiratory disease.

Methods: PM 2.5 and radon samples were taken in homes (n=21) in Central Kentucky. An in- home checklist was completed for each home that assessed a variety of potential environmental respiratory exposures.

Results: The geometric mean of PM 2.5 for all 21 homes was 8.4 μg/m³ which was well below the EPA air quality standard of 35 μg/m³. Smoking status, burning candles, and general …

Analytical High-Resolution Electron Microscopy Reveals Organ-Specific Nanoceria Bioprocessing, Uschi M. Graham, Robert A. Yokel, Alan K. Dozier, Lawrence Drummy, Krishnamurthy Mahalingam, Michael T. Tseng, Eileen Birch, Joseph Fernback

Pharmaceutical Sciences Faculty Publications

This is the first utilization of advanced analytical electron microscopy methods, including high-resolution transmission electron microscopy, high-angle annular dark field scanning transmission electron microscopy, electron energy loss spectroscopy, and energy-dispersive X-ray spectroscopy mapping to characterize the organ-specific bioprocessing of a relatively inert nanomaterial (nanoceria). Liver and spleen samples from rats given a single intravenous infusion of nanoceria were obtained after prolonged (90 days) in vivo exposure. These advanced analytical electron microscopy methods were applied to elucidate the organ-specific cellular and subcellular fate of nanoceria after its uptake. Nanoceria is bioprocessed differently in the spleen than in the liver.

Older Adult Men’S Emotional Bonds With Their Dogs, Ranell L. Mueller

Theses and Dissertations--Gerontology

Knowledge of the deeper meanings of attachment to companion animals is limited, particularly in terms of older adults. This study employed a modified grounded theory method, a phenomenological lens and a life course perspective to gather and analyze data garnered from individual interviews and panel discussions in order to investigate the multiple dimensions of older adult men’s relationships with their companion animal dogs. Individual audio-recorded in-depth interviews and repeated panel discussions with a sub-group of the participants, convened as a panel over a three-month period, explored behavioral and emotional manifestations of attachment and the emotional bond to their companion animal …

Music Training As A Neuro-Cognitive Protector For Brain Aging: Cognitive And Neuropsychological Profiles In Professional Musicians, Catherine E. Schneider

Theses and Dissertations--Gerontology

The proportion of older adults living with cognitive impairments is increasing rapidly. This shift will likely increase mortality rates, reduce perceived quality of life, and cause economic burden to patients and health care systems. Currently evidence of highly effective and noninvasive interventions that prevent or slow the onset of cognitive impairment are limited. This study aims to better understand what drives cognitive aging variability among musicians versus non-musicians. Music playing has been shown to improve brain and cognitive functions by engaging networks of brain areas, simultaneously involving cortical mechanisms associated with executive, high-level cognitive and motor functions, and multiple sensory …

Multivariate Analysis To Identify Potential Biomarkers For Prognosis And Treatment Resistance In Head And Neck Cancer Patients, Christina Ann Wicker

Theses and Dissertations--Toxicology and Cancer Biology

It is estimated that nearly 50,000 individuals in the United States will be diagnosed with head and neck cancer in 2017 (American Cancer Society www.cancer.org). Ninety percent of oral cancers are head and neck squamous cell carcinoma (HNSCC). Major obstacles in the treatment of HNSCC are recurrence and treatment resistance, which contributes to increased mortality. Therefore, there is increased need to determine genetic alterations in HNSCC that may be ideal novel drug targets, and biomarkers to improve diagnostic and prognostic testing.

Abnormal localization and overexpression of base excision repair protein and transcriptional regulator Apurinic/Apyrimidic endonuclease (APE1) has been associated with …

Role Of Oxidized Extracellular Vesicles As Early Biomarkers And Inflammatory Mediators In Chemotherapy-Induced Normal Tissue Injury, Chontida Yarana

Theses and Dissertations--Toxicology and Cancer Biology

Significant advances in the efficacy of cancer therapy have been accompanied by an escalation of side effects that result from therapy-induced injury to normal tissues. Patients with high grade cancer or metastasis are often treated with chemotherapy, 50% of which are associated with reactive oxygen species generation and cellular oxidative stress. Heart is the normal tissue most susceptible to chemotherapy-induced oxidative stress and heart disease is the most common leading cause of death in cancer survivors. However, early and sensitive biomarkers to identify heart disease are still lacking. Extracellular vesicles (EVs) are released from cells during oxidative stress and send …

Understanding Haitian Women’S Health Care In Immokalee, Florida, Usa, Michele Leigh Flippo Bolduc

Theses and Dissertations--Geography

This social science research project takes a critical approach to understanding the health of a population by using the health care system as an entry point through which we can see how large-scale social processes produce a particular health care landscape in the rural, im/migrant farmworker community of Immokalee, Florida, USA. Using a multi-scalar analysis of health care, I investigate how anti-immigrant legislation and neoliberal economics influence the experience of health care for health care providers and Haitian im/migrant women navigating these processes. First, I argue that anti-immigrant and pro-market discourses have been successful in limiting the accessibility to health …

Implementation Of An Evidenced-Based Opioid Treatment Program To Improve Maternal-Child Outcomes In Eastern Kentucky, Jordan Rice

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

The Kentucky River Area District Health Department proposes implementation of CHARM-Kentucky, a treatment program for pregnant women with opioid use disorder (OUD), in eastern Kentucky. Over 115 Americans die each day from an opioid overdose, resulting in approximately 42,000 deaths in 2016. In addition to an overall increase in opioid use in recent years, the use of opioids in pregnancy has also increased from 1.19 per 1,000 hospital births in 2000 to 5.63 in 2009. Opioid use during pregnancy results in poor neonatal outcomes including: low birth weight, preterm delivery, small head circumference, increased child maltreatment, and risk for long-term …

A Program Evaluation Of A Colon Cancer Screening Program Using At-Home Fecal Immunochemical Tests With Certified Patient Navigators, Candace E. H. Brunk

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

Colorectal cancer is the second leading cause of cancer-related death in this country, but 33% of these deaths could be prevented by screening. While colonoscopy is an effective screening tool, it is expensive, invasive, and prone to encounter considerable patient resistance. An alternative is to first screen those at-risk using at-home fecal immunochemical test (FIT) kits. This study determined factors associated with the return of these kits distributed by Kentucky CancerLink, a non-profit organization, and its affiliates to participants in a colon cancer prevention program.

Objectives: To identify factors associated with: completing a FIT kit, completing the kit with minimal …

Epidemiology Of Young Adult Renal Cell Carcinoma In Kentucky: Incidence, Clinicopathologic Features, And Cancer-Specific Survival, Jason R. Bylund

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

Introduction:

Renal cell carcinoma (RCC) is an important cause of morbidity and mortality in our country. Previously reported data suggest that the overall incidence of RCC continues to rise and may be accelerating even faster among younger adult patients.

Methods:

Data for analysis included the combined NPCR-SEER USCS public use database and the Kentucky Cancer Registry dataset. Incidence rates and trends by age group and location were calculated and tested. Clinicopathologic features of disease among Kentucky cases were analyzed by age group. Cancer-specific survival (CSS) analysis was performed, along with Cox proportional hazards regression to test for association of younger …