Medicine and Health Sciences Commons^™

Protection From Aortic Aneurysm By Bmal1 Deletion From Smooth Muscle Cells, Jenny Lutshumba

Theses and Dissertations--Physiology

Abdominal aortic aneurysm (AAA) is a devastating condition that occurs primarily among older people with high mortality when a rupture occurs. Currently there is no proven pharmacological therapy for AAA due to poor understanding of the underlying pathogenesis. The brain and muscle transcription factor ARNT-like (Bmal1), which is known to regulate circadian rhythm, has been implicated in vascular pathologies including atherosclerosis and vascular remodeling, but its role in AAA has not been explored.

Vascular smooth muscle is a central player in aneurysm formation and development because it is critical in all three aortic aneurysm hallmark processes including (a) degradation of …

Neuroinflammation In Alzheimer's Disease And Vascular Cognitive Impairment, Erica M. Weekman

Theses and Dissertations--Physiology

It was once believed that the brain was immunologically privileged with no resident or infiltrating immune cells; however, now it is understood that the cells of the brain are capable of a wide range of inflammatory processes and phenotypes. Inflammation in the brain has been implicated in several disease processes such as Alzheimer’s disease (AD) and vascular cognitive impairment and dementia (VCID); however, the role of inflammation in these two dementias is poorly understood.

When we stimulated a pro-inflammatory phenotype with an adeno-associated viral vector in a transgenic mouse model of AD that develops Aβ plaques, we saw a pro-inflammatory …

New Insights Into Post-Sepsis Muscle Weakness Elucidated Using A Novel Animal Model, Allison M. Steele

Theses and Dissertations--Physiology

Sepsis is a severe life-threatening critical illness that damages multiple physiological systems. After hospital discharge, more than 70% of severe sepsis survivors report profound weakness which significantly impacts quality of life. Such weakness gives rise to new limitations of daily living, which ultimately leads to loss of independence in many patients. Despite wide recognition of this serious issue by clinicians and researchers alike, the mechanisms contributing to chronic skeletal muscle dysfunction after sepsis are not well understood. Lack of progress in this field is largely due to the absence of an appropriate animal model; current models are either too mild …

Role Of Skeletal Paracrine Signals In The Proliferation And Chondrogenic Differentiation Of Interzone Cells, Parvathy Thampi

Theses and Dissertations--Veterinary Science

Articular cartilage in mammals has a limited intrinsic capacity to repair structural injuries and defects, a fact that contributes to the chronic and progressive nature of osteoarthritis. Current treatment modalities do not enable articular cartilage to achieve a complete and permanent restoration of normal structure and function with large or partial thickness lesions. In contrast to mammals, Mexican axolotl salamanders (Ambystoma mexicanum) have demonstrated the remarkable ability to spontaneously and completely repair even large joint cartilage lesions, an intrinsic healing process that involves interzone cells in the intraarticular space. Further, when interzone tissue is transplanted into critical sized …

Biology And Detection Of Pregnanes During Late Gestation In The Mare, Michelle Arelia Ann Wynn

Theses and Dissertations--Veterinary Science

Progesterone in the mare declines to almost undetectable concentrations in late gestation. It’s metabolized into several pregnanes, some circulating at very high concentrations. Although the function of many pregnanes remains unclear, 5α-dihydroprogesterone and allopregnanolone are bioactive. Measurements of pregnanes in late gestation are typically by immunoassay, although results are confounded by cross-reactivity with related pregnanes. Conversely, liquid chromatography tandem mass spectrometry (LC-MS/MS) allows differentiation of individual pregnanes. The purposes of these studies were: 1) to evaluate the ability of a 5α-reductase inhibitor, dutasteride, to alter pregnane metabolism and pregnancy outcome, 2) to evaluate changes in target pregnanes in late gestation …

An Investigation Into Specific Seminal Plasma Proteins And Their Effect On The Innate Immune Response To Breeding In The Mare, Carleigh Elizabeth Fedorka

Theses and Dissertations--Veterinary Science

The mare experiences a transient innate immune response to breeding, the resolution of which is crucial for optimal fertility. The majority of mares are able to modulate this inflammation in a timely fashion, but a subpopulation exists which fail to do so and are considered susceptible to persistent breeding-induced endometritis (PBIE). Seminal plasma has been shown to modulate aspects of this inflammation. Recently, two seminal plasma proteins have garnered interest for their immune modulating properties: cysteine-rich secretory protein-3 (CRISP-3) and lactoferrin. These proteins have been found to alter the binding between sperm and neutrophils based on sperm viability in vitro …

Analysis Of Humoral Immune Responses In Horses With Equine Protozoal Myeloencephalitis, Catherine-Jane Angwin

Theses and Dissertations--Veterinary Science

Equine protozoal myeloencephalitis (EPM), caused by the protozoan parasite Sarcocystis neurona, is one of the most important neurological diseases of horses in the Americas. While seroprevalence of S. neurona in horses is high, clinical manifestation of EPM occurs in less than 1% of infected horses. Factors governing the occurrence and severity of EPM are largely unknown, although horse immunity might play an important role in clinical outcome. We hypothesize that EPM occurs due to an aberrant immune response, which will be discernable in the equine IgG subisotypes a, b, and (T) that recognize S. neurona in infected diseased horses versus …

Inflammation And Insulin Dysregulation In The Horse, Sarah E. Elzinga

Theses and Dissertations--Veterinary Science

Insulin dysregulation (ID) in the horse is receiving increasing attention as a serious health concern, in particular due to its association with the potentially career or life ending condition, laminitis. The role of inflammation and the immune system in ID as well as its associated health concerns has also been raised. However, the involvement of inflammation in and mechanisms behind ID in the horse remain unclear. Therefore, our overall hypothesis was that due in part to changes in their gut microbiota and plasma lipidome, horses with ID have changes in circulating proinflammatory markers, in particular in response to glycemic challenge, …

Lymphocyte-Mediated Inflamm-Aging In The Horse, Melissa Hope Siard

Theses and Dissertations--Veterinary Science

Senior horses (≥20 years) exhibit inflamm-aging, or chronic, low-grade inflammation that occurs systemically with aging, similarly to humans. Inflamm-aging has previously been characterized in the horse in circulation as well as specifically being mediated by lymphocytes and monocytes. In humans, inflamm-aging has been associated with increased morbidity and mortality. However, in the horse, relatively little about inflamm-aging is known regarding clinical effects or factors influencing severity. The contribution of lymphocytes to inflamm-aging of senior horses was examined, specifically through determining the relationships of inflamm-aging with various other health parameters, effects of seasonality, and the extent to which inflamm-aging can be …

Physiological Changes Associated With Pregnant Or Nonpregnant Mares Grazing Pastures Of Orchardgrass-Bluegrass, Kentucky 31 Tall Fescue Infected With Epichloë Coenophiala, Or Kyfa9821 Tall Fescue Infected With The Novel Endophyte Ar584, Victoria A. Taylor

Theses and Dissertations--Veterinary Science

Kentucky 31 tall fescue (KY31) infected with the common toxic endophyte strains of Epichloё coenophiala produces toxic alkaloids that improve plant vigor, but cause numerous adverse effects in grazing animals. Researchers developed a variety of KY31 containing an alternative strain of E. coenophiala, termed novel endophyte (NE). Adverse health effects in mares have not been evaluated.

Experiments in this thesis tested the hypothesis that the NE pasture does not cause adverse effects typically associated with KY31. Specific aims were to: 1) compare forage ergovaline concentrations between KY31 vs NE pastures; 2) evaluate palmar artery diameters in mares grazing KY31, …

Evaluation Of Pyriproxyfen Applied In Barrier Sprays For Mosquito Suppression, Andrea Glenn Skiles

Theses and Dissertations--Entomology

Despite advances in mosquito management, mosquito-borne disease in the United States is still of relevant public health concern and vector control is a top priority in preventing transmission of pathogens. Insecticide barrier sprays have become a common tool for suppression of mosquitoes in single-homeowner backyards. The application of the synthetic pyrethroid, lambda-cyhalothrin to perimeter vegetation with a backpack sprayer has been shown to significantly suppress mosquito levels for around 6 weeks. In an attempt to lengthen the effective duration of treatment, the IGR, pyriproxyfen, was added to a backpack mist blower with lambda-cyhalothrin, as adult mosquitoes exposed to pyriproxyfen have …

Formative Evaluation Of A Family Cooperation Board Game, Joseph Hannan

Theses and Dissertations--Family Sciences

A lack of credible evidence demonstrating the effectiveness of play therapy and the use of therapeutic board game in play therapy exists (Phillips, 2010; Matorin, 1996). Parent involvement is a key variable in the effectiveness of play therapy (Kottman, Stother, and Deniger, 2001). Formative research was used in this study to evaluate of The Super Family Board Game™ (SFBG) in order to develop an effective therapeutic board game aimed at enhancing family cooperation and cohesion. As the first formative evaluation of a therapeutic board game, this study provides future research implications for developing and testing therapeutic board games.

Emerging Adults And Recovery Capital: Barriers And Facilitators To Recovery, Alex Elswick

Theses and Dissertations--Family Sciences

Substance use disorders are chronic brain disorders and must therefore be treated on an ongoing basis. Accordingly, the concept of recovery capital has been developed to account for the internal and external resources that an individual can mobilize in order to recover from a substance use disorder. However, the concept has scarcely been applied to emerging adults. Although they are at twice the risk of developing a substance use disorder relative to their adult or adolescent counterparts, emerging adults in addiction and recovery are understudied. This phenomenological study aims to explore and describe the experience of emerging adults in recovery …

Comparing Mindfulness-Enriched Weight Management To Current Standard Practices, Teresa M. Lee

Theses and Dissertations--Nutrition and Food Systems

Mindfulness-based interventions have been shown to be effective for numerous diet-related conditions. Mindfulness skills have been theorized to be helpful in improving eating behaviors, and thereby weight management. The purpose of this study was to compare the effectiveness of a mindfulness-enriched weight management program to a standard weight loss program over the course of a 12-week intervention, and weight maintenance over six months. This was a two-group randomized experimental design. One group received a standard weight loss program, while the other group received the same program with an additional mindfulness component. Follow up assessments were conducted twice at three-month intervals. …

Social Marketing Campaign At Farmers' Markets To Encourage Fruit And Vegetable Purchases In Rural Counties With A High Obesity Prevalence, Emily M. Dewitt

Theses and Dissertations--Nutrition and Food Systems

Farmers’ markets are one food environment venue with the potential to increase fruit and vegetable consumption among rural residents in the United States. This study used the Plate It Up Kentucky Proud social marketing campaign in six rural communities over two years to determine the association between exposure to the campaign and fruit and vegetable purchasing decisions. The availability of recipe cards at the farmers’ market was associated with influencing the purchase of fruits and vegetables (p<0.001); the recipe sample was associated with buying the ingredients for the recipe (p<0.001); taking the PIUKP food sample was associated with a willingness to prepare the food item at home (p<0.001). Utilizing social marketing strategies at farmers’ markets may be an effective way to improve fruit and vegetable intakes in rural communities.

Changes Of Percent Body Fat, Waist Circumference And Fruit And Vegetable Intake Among Division I Collegiate Female Softball Players After Nutrition Curriculum Paired With Technology, Rachel Thomas

Theses and Dissertations--Nutrition and Food Systems

Previous research has found that the quality and intake of collegiate athletes’ diets does not meet the recommended standards. Little research has been completed in regards to the diets of collegiate female softball players. The purpose of this research study was to determine if an 11-week nutrition curriculum paired with a technology could increase fruit and vegetable consumption while decreasing percent body fat and waist circumference. The sample included 14 female softball players. Paired t-test were preformed to compare fruit and vegetable intake, body fat percentage, and waist circumference pre- and post-intervention. Linear regression models were used to determine correlations …

Couples And Weight Loss Surgery: Experiencing Success, Amanda L. Westmoreland

Theses and Dissertations--Family Sciences

Bariatric surgery, also known as weight loss surgery (WLS) is an intervention for individuals who are suffering from obesity and weight-related health complications which often accompany being 100 pounds or more overweight (Smith et al., 2011). Even though bariatric surgery has been shown to be a life-saving and life-enhancing operation, efforts to seek out surgery options, qualify and prepare for the procedure, recover from surgery, and then adapt new routines to support surgery are challenging not only for the patient, but also for the people with whom the patient spends the most time—their romantic partners (Applegate & Friedman, 2008; Bylund, …

Finding The Link Between Social Connectivity And Dietary Intake Among Rural Adolescents In North Carolina And Kentucky, Jordan Elizabeth Mcdonald

Theses and Dissertations--Nutrition and Food Systems

Social networks play a significant role in adolescent decision making, specifically when it comes to dietary outcomes. This study, granted by the United States Department of Agriculture (USDA), assessed the connectivity of these social networks and the impact they have on fruit and vegetable, added sugar and sugar sweetened beverage consumption. Additionally, the relationship between shopping companionship and dietary choices was studied. Positive and negative associations were found among adolescents who shop with parents or friends. It was also found that those adolescents with greater social network cohesion were found to have more negative dietary outcomes. Divulging further into the …

Connecting Self-Efficacy Of Dietary Choices And The Association With Dietary Intake Among Rural Adolescents In North Carolina And Kentucky, Rachel Gillespie

Theses and Dissertations--Nutrition and Food Systems

Determining the level of belief one has in themselves, or their self-efficacy, can be a key factor to improve certain dietary patterns and choices in the rural youth population. Sugar sweetened food and beverage consumption continues to rise and fruit and vegetable intake remains a struggle in rural areas; addressing both the food environment and adolescents’ self-efficacy could have a lasting impact on changing the nature of a generation of rural student’s food and beverage choices. This study measured self-efficacy levels of (n=425) adolescents in rural Kentucky and North Carolina using the Youth Impact Questionnaire and dietary intake using the …

The Effects Of A 16-Week Introductory Nutrition Course On Dietary Habits And Body Composition Of College Students, Emily Ashton

Theses and Dissertations--Nutrition and Food Systems

As the rates of obesity continue to increase among adolescents and young adults, adopting healthy dietary and lifestyle habits is necessary in order to prevent obesity-related chronic disease later in life. Although several studies have addressed nutrition education and its effect on weight in college students, few studies have assessed percent fat as it relates to a semester-long nutrition course. As such, the effectiveness of a formal introductory nutrition course on lifestyle habits and percent fat of college students was examined. The current study aimed to address the relationship between percent body fat and nutrition education over the course of …

Resources And Well-Being In Amyotrophic Lateral Sclerosis Patients And Caregivers: A Longitudinal, Dyadic Analysis, Suzanne C. Segerstrom

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

Socioemotional selectivity theory predicts that as the end of life approaches, resources that provide immediate, hedonic reward become more important and resources that provide delayed rewards become less important. The present study tested the theory in the context of marital dyads in which one partner had been diagnosed with amyotrophic lateral sclerosis (ALS), a terminal disease. ALS patients (N = 102) and their spouses (N = 100) reported their loneliness, financial worry, and psychological health every 3 months for up to 18 months. In multilevel dyadic models, patients and spouses had similar levels of financial worry and loneliness, but spouses’ …

Diagnostic Prevalence Of Diabetes Among Older Adults In Rural Appalachia, Gabriella Hodges

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

Background

The rural, mountainous Appalachian region continuously has poorer health outcomes than the rest of the United States. This is true for many chronic diseases including diabetes: the 7th leading cause of death in the United States. This study assessed differences in the prevalence of diagnosed diabetes between older adults in rural, Appalachian counties and rural, non- Appalachian counties.

Methods

Data for the year 2013 was extracted from the Centers for Medicare and Medicaid Services (CMS) Public Use Files for Medicare beneficiaries (September 2015), which provides county level prevalence for diabetes as well as several other conditions among Medicare fee-for-service …

Community Based Sexual Education In Hamilton County Ohio, Jennifer Winbigler

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

This project proposes the implementation of a community-based sexual education program in Hamilton County Ohio. The proposed program is Focus on Youth + ImPACT. FOY + ImPACT is an evidenced based intervention focused on providing knowledge and skill based education to both youth (during FOY sessions) and parents (during the ImPACT session). The educational program will be implemented at three sites: the Boys and Girls Club of Greater Cincinnati, Lighthouse Youth Services, and Caracole. Each site was selected for its current infrastructure conducive to youth programming. This included ease of access to youth as well as experience in the provision …

Addressing Barriers To Hepatitis C Treatment Initiation In Kentucky Clinic, Moaz Abdelwadoud

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

Introduction. Hepatitis C virus (HCV) is the most prevalent blood borne infection in the United States and its chronic infection has a high burden on the American healthcare system. Since 2014, the all-oral Directly Acting Antiviral (DAA)-based therapy has been established as the standardized curative treatment for HCV with unprecedented high effectiveness and tolerability. Nevertheless, there is a significant gap between the promise from DAAs benefits and the treatment initiation rates in the United States and Kentucky.

Objectives. The goal of this study is to improve the access to the all-oral DAA-based treatment among HCV patients seeking outpatient …

The Impacts Of Recreational Marijuana Legalization On Colorado Policy Analysis On Amendment 64, Santhi Chilukuri

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

This report is a policy analysis on the impacts of Colorado’s Amendment 64. Marijuana is the most commonly used illicit drug in the U.S, and a Schedule 1 Drug under the federal government. Despite this, twenty-nine states and territories in the U.S. have legalized it for medicinal purposes; (Hanson NCSL, 2017) four of which legalized it for recreational purposes. (Hall & Lynskey, 2016) Medical Marijuana has been legal in Colorado since 2009; however, Amendment 64 was passed in 2012 which legalized the possession, retail sale, and purchase of marijuana to Colorado state residents 21 and over. Commercialization in retail stores …

Assessing Provider Adherence To The 2013 Acc/Aha Hyperlipidemia Guideline, Adrienne Johnston

DNP Projects

Background: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in the United States and accounts for more than 17.3 million deaths per year with hyperlipidemia as one of the leading risk factors. The 2013 American Heart Association/American College of Cardiology (AHA/ACC) hyperlipidemia guideline recommends healthy lifestyle habits, risk estimation of the development of cardiovascular disease using a risk calculator, and intensity dosed statin therapy. There has been controversy among providers resulting in confusion and inconsistent application of the guideline. Purpose: The purpose of this project was to examine provider adherence to the AHA/ACC hyperlipidemia guideline in a primary …

Evaluation Of Kentucky Nurses' Knowledge And Self-Efficacy Related To Safe Sleep And Sudden Unexpected Infant Death Risk-Reduction Strategies, Lisa Mcgee

DNP Projects

Sudden Unexpected Infant Death (SUID) claims the lives of about 3700 infants in the United States each year (CDC, 2015). It is the second leading cause of infant death in Kentucky (KDPH,2015) where it has a rate almost three times that of the nation. The American Academy of Pediatrics (AAP) has made recommendations to decrease the risk of SUID and indicates hospital professionals, including nurses, have a responsibility to educate and model safe sleep strategies for parents. An evaluation of the knowledge and self-efficacy about safe sleep and SUID risk-reduction strategies of neonatal and perinatal nurses in Kentucky birthing and …

Serve Volume: How Important Is It?, Natalie L. Myers, W. Ben Kibler, Timothy L. Uhl

Physical Therapy Faculty Publications

No abstract provided.

Neuropathological And Genetic Correlates Of Survival And Dementia Onset In Synucleinopathies: A Retrospective Analysis, David J. Irwin, Murray Grossman, Daniel Weintraub, Howard I. Hurtig, John E. Duda, Sharon X. Xie, Edward B. Lee, Vivianna M. Van Deerlin, Oscar L. Lopez, Julia K. Kofler, Peter T. Nelson, Gregory A. Jicha, Randy Woltjer, Joseph F. Quinn, Jeffery Kaye, James B. Leverenz, Debby Tsuang, Katelan Longfellow, Dora Yearout, Walter Kukull, C. Dirk Keene, Thomas J. Montine, Cyrus P. Zabetian, John Q. Trojanowski

Sanders-Brown Center on Aging Faculty Publications

Background

Great heterogeneity exists in survival and the interval between onset of motor symptoms and dementia symptoms across synucleinopathies. We aimed to identify genetic and pathological markers that have the strongest association with these features of clinical heterogeneity in synucleinopathies.

Methods

In this retrospective study, we examined symptom onset, and genetic and neuropathological data from a cohort of patients with Lewy body disorders with autopsy-confirmed α synucleinopathy (as of Oct 1, 2015) who were previously included in other studies from five academic institutions in five cities in the USA. We used histopathology techniques and markers to assess the burden of …

Retention In Continuous Care And Sustained Viral Suppression: Examining The Association Among Individuals Living With Hiv, Timothy N. Crawford, Alice C. Thornton

Internal Medicine Faculty Publications

Objectives: To examine the relationship between retention in continuous care and sustained viral suppression.

Methods: The authors retrospectively followed 653 persons who were virally suppressed and seeking care at an infectious disease clinic in Kentucky for an average of 6 years to determine the rates of retention in medical care (≥2 visits separated by ≥3 months within a 12-month period) and sustained viral suppression (<400 copies/mL). A generalized linear mixed model was used to determine an association between retention and suppression over time.

Results: Approximately 61% of the study population were retained in continuous care and 75% had sustained viral suppression for all patient-years. Persons retained in care were 3 times the odds of sustaining viral suppression over …