Medicine and Health Sciences Commons^™

Forced Sexual Intercourse And Its Link To Suicide Ideation/Suicide Attempts Among Adolescent Girls: Findings From 2013 Youth Risk Behavioral Survey, Adebukola Helen Adegbite

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

Objectives. We sought to assess the association between forced sexual intercourse and suicidal ideation/attempts among adolescent girls ages 14-17.

Methods. We performed secondary data analysis of the 2013 Youth Risk Behavioral Survey, using chi-square tests to examine the association of forced sex and race/ethnicity, with suicide ideation.

Results. We found that there was an association between those who had considered suicide and those who had experienced forced sexual intercourse. Moreover, race/ethnicity was associated with those who had ever considered suicide in the past 12 months before taking the survey. Lastly, we found that there was an association of suicide ideation …

Development Of Multiple Primary Cancers In Lung Cancer Patients: Appalachian Vs. Non-Appalachian Populations Of Kentucky, Vira Pravosud

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

OBJECTIVE: This study examined whether there were differences in the development of multiple primary cancers in lung cancer patients residing in the Appalachian versus Non-Appalachian regions of Kentucky. The study also identified other factors associated with the development of another primary cancer in lung cancer patients.

HYPOTHESIS: Lung cancer patients residing in Appalachian Kentucky are more likely to develop multiple primary cancers compared to patients residing in Non-Appalachian Kentucky.

METHODS: This was a retrospective, population-based cohort study of Kentucky patients (N=26456) aged 20 years and older, diagnosed with primary lung cancer between January 1, 2000 and December 31, 2013. The …

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

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

Introduction:

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

Background:

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

Identifying Predictors Of Functional Limitations Associated With Depression, Anxiety, And Emotional Problems In Us Adults, Jillian Richardson

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

Depressive disorders are characterized as sharing affected mood, and somatic (e.g. sleep pattern, appetite, and unintentional changes in weight) and cognitive alterations from previous normal daily functioning that are clinically significant. Anxiety disorders are characterized by excessive fear, general or specific anxiety, and related behavioral disturbances that are also clinically significant. This project attempts to identify risk factors that may predict what groups are most likely to be affected by depression and/or anxiety.

Sponsored by the CDC, the National Health Interview Survey collects general health information for non-institutionalized individuals living in the US. Variables for use in logistic regression model …

"Life Skills Training" Prescription Drug Abuse Prevention Among Youth In Bell County, Kentucky, Arveen Kaur

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

Prescription Drug Abuse (PDA) has become a serious public health concern and a major epidemic in the United States (U.S.). According to the 2014 National Survey on Drug Use and Health (NSUDH), approximately 15 million people (aged 12 or older) used prescription drugs in the past year and 6.5 million in past month. Out of these, 2 million Americans (aged 12 or older) either abused prescription drugs or were dependant on them. Almost 5% of adolescents (1.1 million) between the age group 12-17 abused prescription painkillers in 2014. Nationally, Kentucky is among the top five states with highest age-adjusted overdose …

Hispanic Agricultural Workers: The Nexus Of Demographics, Employment Characteristics, And Health, Ashley Michelle Bush

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

Agriculture, which is home to elevated occupational injury and illness rates, has a substantial demographic makeup of Hispanic workers. Hispanic farmworkers are at increased risk of poor occupational health outcomes due to the precarious nature of work and other socio-ecological influences. These adverse occupational health outcome counts are inadequate and undercounted, failing to capture the true scope of agricultural work. To gain more knowledge about agriculture, this capstone will focus on the personal and work characteristics of agricultural workers to help further understand disparities within the agricultural sector by: providing a literature review of agricultural worker health; examining missed work …

Hiv Risks, Intimate Partner Violence (Ipv), And Depression Among A Sample Of Women Who Have Sex With Men And Women (Wsmw), Krystal S. Frieson

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

Objective: The purpose of this study is to examine the associations between interpersonal partner violence (IPV), HIV risks, and depression among a sample of adolescent females who have sex with men and women.

Methods: A cross-sectional study was conducted using data from the Youth Risk Behavior Surveillance System (YRBSS). YRBSS data was obtained from representative samples of students in grades 9-12. The study sample was comprised of adolescent and young women who self-identified as having sex with men and women (WSMW)(N=526). The primary exposure was sexual behavior (having sexual intercourse with both male and female partners). The primary outcomes were …

Are There Rural-Urban Differences In Dentist Supply?, Mutlaq Alotaibi

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

The purpose of this project was to examine the supply of dentists in the Commonwealth of Kentucky at the county level. Counties with shortages in dentist supply were determined and associated factors were examined.

Several county-level variables were analyzed. These included total number of dentists, total county population, dentist to population ratio, dentist supply shortage, median household income, median age, percent of Medicaid enrollees, rurality, oral cancer crude incidence and mortality rates per 100,000 and percent of adults missing six or more teeth.

This project showed that 42 of the 120 counties in Kentucky had shortages in dentist supply. Also, …

Policy And Political Motives For Medicaid Expansion Under The Patient Protection And Affordable Care Act, Ross C. Stanton

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

Objective

This study aims to analyze policy-related and political rationales for Medicaid expansion under the Patient Protection and Affordable Care Act (PPACA). More specifically, this study seeks to discover whether states’ decisions regarding Medicaid expansion were likely based on policy implications regarding the uninsured or political motives.

Methodology

The approach is a cross-sectional/observational study of American states and the District of Columbia after the Sebelius decision in 2012. This study compares three variables: (1) whether each state decided to opt into the expansion (“Opted In”), (2) whether each state’s governor and legislature were affiliated with either the Democratic or Republican …

The Association Of Atrazine And Non-Hodgkin Lymphoma In Kentucky, Justine F. Maxwell

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

Atrazine, one of the most widely used agricultural pesticides, largely sprayed on corn. throughout the Midwest.34 The Environmental Protection Agency (EPA) has estimated 76.4 million pounds are applied annually where its usage on corn accounts for approximately 86% of total United States (US) domestic usage (in pounds).35 Approximately 75% of the field corn acreage grown in the U.S. is treated with atrazine.35 Once atrazine enters into waterways, it can persist having a half-life greater than 200 days in surface waters.34 In Kentucky, atrazine is the most heavily applied in heavy corn-producing locations, which are mostly in western regions of the …

Analysis Of Firearm Legislation And Law Enforcement Suicides In Nvdrs-Funded States, Meagan L. Hurst

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

BACKGROUND:

The purpose of this study was to evaluate firearm-related suicides among law enforcement members and identify potential differences between decedents and firearm legislation grades from National Violent Death Reporting System (NVDRS) funded states

METHODS:

Descriptive and regression analyses were conducted using suicide data from 820 decedents who worked within law enforcement at the time of death. Data were collected over a ten-year period (2003-2013) from the NVDRS. Multivariable logistic regression and Pearson’s chi-square were used to identify if differences existed among firearm-related suicides and other means using variables such as age, marital status, occupation, mental health, and firearm legislation …

Service Training And Recovery (Star) Program: An Interdisciplinary Community-Based Project To Mitigate Rr-Ptsd Among Kentucky Women, Margaret Melissa Brown

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

Background: Kentucky has greater prevalence of sexual assault compared to the US overall, 37.5% versus 35.6% of all assault crimes respectively, translating to roughly 638,000 victims within the Commonwealth [1].Research identified sexual violence as the number one factor in development of PTSD among women. There are four times the prevalence of PTSD in victims of sexual violence versus other forms of trauma. [2, 3] The STAR program utilizes skills-based training methods to empower participants through improving a sense of safety and security, self-confidence, and self-efficacy to mitigate RR-PTSD symptoms leading to negative health outcomes.

Literature Review: Existing research …

Circumstances Contributing To Suicides Among Pregnant, Postpartum And Non-Pregnant Women (15 - 54 Years) In Rural And Urban Counties In The U.S., Nvdrs 2003-2012, Akosua Korantema Adu

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

Abstract withheld upon request.

Undiagnosed Hepatitis C Infection In An Urban Emergency Department, Naseem Ansari

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

Aim: To evaluate the prevalence of previously undiagnosed hepatitis C virus and associated patient risk factors in an urban ED through a universal, integrated screening program, to contextualize results found in terms of gaps in existing HCV screening models and to inform future sustainable and effective screening models.

Methods: ED patients, ages 18-71, that were medically stable, hadn’t had a prior HCV test, and were having blood drawn as part of routine clinical care, were offered (n=2,726) an anti-HCV test, of whom 1,945 accepted. An assessment of correlates to anti-HCV positivity was completed using a binomial logistic regression …

Pre-Antibiotic Therapy Of Syphilis, Charles T. Ambrose

Microbiology, Immunology, and Molecular Genetics Faculty Publications

The explosive increase in syphilis throughout China and Russia during the past several decades represents a global public health threat for several reasons. 1) Most cases are undertreated and thus collectively offer optimal conditions for the emergence of resistant strains of the syphilis spirochete, Treponema pallidum. No penicillin-resistant strains have been recognized to date, but strains resistant to the second line antibiotic agents are now common. 2) The recent discovery of plasmids in T. pallidumraises the likelihood of plasmid transfer from other bacteria of various resistance genes, especially those directed toward penicillin-type antibiotics, currently the drugs of choice for …

Cns Plasticity In Injury And Disease, Brandon A. Miller, John C. Gensel, Michael S. Beattie

Spinal Cord and Brain Injury Research Center Faculty Publications

No abstract provided.

Reduction Of Fecal Coliform Bacteria Through The Elimination Of Sewage Discharges In West Virginia Streams, Kady Rogers

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

Background and Objectives

Early environmental regulations such as the Federal Water Pollution Control Act of 1948, and the 1972 amendments—which would later become known as the Clean Water Act—have improved the quality of the drinking and recreational waters here in the United States. This has been achieved as a result of strict regulations on discharges, proper management strategies, as well as thorough sampling and testing for contaminants. One such contaminant is fecal waste; these materials are a public health concern because of the potential risk of gastrointestinal diseases. Scientists have used fecal coliforms as an indicator of the presence of …

A Comparative Study Of Ever And Never Smokers With Bronchiectasis, Laura Higdon

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

Objective: The objective of the study is to predict the odds of death in participants with bronchiectasis and to determine if ever smokers have increased odds of death when compared to never smokers.

Methods: Data for the study was used from the Bronchiectasis Research. Pearson chi square test is used to compare never smokers to ever smokers for age, gender, and participants enrolled status. Logistic regression is used to predict the odds of death for smoking status, age, gender, or CT scan findings. CT scan findings for this study are dilated airways, airways that are thickening, tree-in-bud infiltrates or mucoid …

Overdose Education And Naloxone Distribution By Board-Certified Pharmacists In Five Eastern Kentucky Counties, Laura Elizabeth Broughton

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

The Coalition of Kentucky Health Professionals Against Substance Abuse (CKHPASA) is a professional organization uniting members of the various health professions against a rising tide of substance abuse in the state of Kentucky. In 2013, Kentucky ranked 3rd in the United States for highest number of drug overdose fatalities. Previously under the scourge of the prescription opioid epidemic, the state of Kentucky is now seeing rising numbers of overdose deaths related to heroin use, which is an opioid that works similarly to morphine and prescription pain medications.

Naloxone is a life-saving antidote for opioid related overdoses and evidence has shown …

Improving Indoor Air Quality For Children In Rural Kentucky, Denerica L. Curry

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

Community interventions directed towards improving indoor air quality for children are often implemented after exposure has occurred and focuses on parental smoking cessation. Our proposed project will intervene during the prenatal stage prior to exposure and continue to support families 6 months postpartum. Infants are at an increased risk of secondhand smoke exposure due to the amount of time they spend in the home and proximity to the smoker. We hypothesize that by enhancing care of the current home visitation model to include an early intervention we will increase the amount of smoking bans in the home and decrease maternal …

Characterizing Health Risks In Privately-Supplied Drinking Water Due To Agricultural Practices In Rural Western Kentucky, Karen Schroeder Card

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

At least 400,000 people in Kentucky rely on private water wells or springs for drinking water. 551 households that rely on private water wells for drinking water were surveyed in 2009 about adverse health outcomes, including selected cancer incidence, adverse birth outcomes, and yearly incidence of diarrheal illness. Survey recipients were drawn from a population of well owners in the Jackson Purchase Region of Kentucky whose wells were tested for nitrate-nitrogen (NO3-N), triazine pesticides, and E. coli or total coliforms, by Kentucky Geologic Survey within the previous 15 years. 214 questionnaires were returned and matched to water quality data for …

Evaluations Of Patients’ Appointment Duration By Type In An Ophthalmology Practice, Brittany U'Wren

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

Objective: The Affordable Care Act expanded health care coverage and provided more access to physicians, resulting in potentially longer wait times. Large portions of ophthalmology patients are on Medicare. Two thirds of the expansion populations were Hispanic or African Americans, which have higher rates of eye disease. Another contributoring factor leading to the increase for eye care is the surge of baby boomers. More specifically, these are individuals reaching sixty-five and are beginning to utilize Medicare. Access to care has increased but the capacity of the practice has not. An important goal, therefore, is to maximize efficiency of current …

A Practice Improvement Project To Improve Knowledge And Perceptions Of Palliative Care Among Patients With Heart Failure And Cancer In The Acute Setting Using Video Enhanced Education, Crystal F. Spellman

DNP Projects

Background: Clear communication of the purpose and benefits of palliative care can reduce barriers to acceptance of such services for patients and families. The purpose of this practice improvement project was to assess and improve knowledge and perceptions of palliative care among patients with a diagnosis of heart failure and cancer in the acute setting using a video enhanced education intervention. Methods: This practice improvement project took place at a 555 bed teaching hospital. 18 patients referred to an inpatient palliative care consult service in the acute care setting with a diagnosis of either heart failure or cancer participated. …

A Debriefing Technique In High-Fidelity Patient Simulation And Competent Decision-Making Abilities Among Nursing Students, Trena Seago

Theses and Dissertations--Curriculum and Instruction

Nursing faculty are utilizing high-fidelity patient simulation (HPS) with debriefing to help engage nursing students in making competent clinical decisions. This quasi-experimental study examined the use of HPS with debriefing and students’ ability to make nursing care decisions using standardized exams. The experimental group received debriefing after HPS and the control group did not receive debriefing after HPS. The pre- and post-test assessed participants’ ability to make clinical care decisions. The analysis of the pre-test and post-test HESI scores showed that there was no significant difference between the two groups.

Lifestyle Contributors To Cardiovascular Disease Risk, Adam J. Berrones

Theses and Dissertations--Kinesiology and Health Promotion

Aortic stiffness is an independent risk factor that has prognostic value regarding future cardiovascular disease (CVD) events such as myocardial infarction, strokes, and heart failure. Although death rates due to coronary heart disease have declined in recent years, the leading global killer remains CVD and prevalence is still high. Understanding lifestyle contributors associated with aortic stiffness would provide the public with insight into targeting key health-related behaviors.

The purpose of this observational study was to examine the association of physical activity, physical function, and dietary quality as independent factors contributing to aortic stiffness in apparently healthy middle aged men. Fifty-two …

The Effect Of Curcumin On Cardiovascular Health In Obese Men, Marilyn S. Campbell

Theses and Dissertations--Kinesiology and Health Promotion

Cardiovascular disease is the leading cause of death in the United States, and conventional treatment often emphasizes pharmaceutical approaches. Research has recently started exploring non-pharmaceutical approaches, including nutritional interventions. This research study was conducted to test the effectiveness of a novel nutritional approach, curcumin, on the improvement of cardiovascular health in young, obese males (BMI≥30 kg/m²). This study included 22 men, matched based on BMI and randomly assigned to the intervention (n=11) or placebo group (n=11). The intervention consisted of 12 weeks of curcumin supplementation (1.0 g/day) with fenugreek added to enhance the curcumin bioavailability; the placebo consisted …

The Role And Impact Of School Nurses And Intentions To Delegate Diabetes-Related Tasks Amidst Budget Cuts And Legislative Changes, Michelle J. Lineberry

Theses and Dissertations--Kinesiology and Health Promotion

As the percentage of school children with chronic conditions such as diabetes continues to rise, funding for school nurses to keep those students healthy and safe is decreasing. This dissertation includes three studies: (1) a systematic review of the literature on the role and impact of American elementary school nurses, (2) a focus group study that further examined the role of Kentucky school nurses and described their reaction to a new regulation that necessitates delegation of diabetes-related nursing tasks to unlicensed assistive personnel (UAP), and (3) a quantitative study that examined Kentucky school nurses’ past behaviors and future intentions regarding …

Central And Peripheral Weight Gain Affect Trunk Kinematics And Lower-Extremity Muscle Activation Differently During Sit-To-Stand, Michelle Christine Walaszek

Theses and Dissertations--Kinesiology and Health Promotion

Background: Obesity-induced alterations in biomechanics and muscle recruitment during activities of daily living, such as sit-to-stand (STS) are often attributed to increases in adipose tissue (AT) mass. Central or peripheral distribution of AT may differently affect biomechanics and muscle recruitment.

Methods: Fifteen healthy, normal weight (BMI 22.4 ± 1.9 kg/m², 24.1 ± 4.2 years) subjects volunteered. External loads equivalent to a 5 kg/m² BMI increase were applied in three conditions: unloaded (UN), centrally loaded (CL), and peripherally loaded (PL). Subjects completed three successful STS movements in a backless chair under each load condition in random order. Motion …

Static Stretching And Preconditioning Exercise Augments Power Output In Recreational Athletes, Mark R. Mason

Theses and Dissertations--Kinesiology and Health Promotion

The purpose of this study was to determine the independent and combined effects of performing a preconditioning exercise and antagonist stretching on vertical jump (VJ) performance. Twenty club rugby players performed a VJ in four conditions: control condition, following static stretching, following a preconditioning exercise, and following the combined treatment of static stretching and a preconditioning exercise. Electromyographic (EMG) activity was measured in the gluteus maximus, vastus lateralis, gastrocnemius medialis, and tibialis anterior during the VJ trials. Repeated measures ANOVA were used to compare VJ and EMG outcomes across conditions. A Bonferroni correction was used to account for multiple post-hoc …

Surface-Initiated Polymerizations For The Rapid Sorting Of Rare Cancer Cells, Jacob L. Lilly

Theses and Dissertations--Chemical and Materials Engineering

Cancer metastasis directly accounts for an estimated 90% of all cancer related deaths and is correlated with the presence of malignant cells in systemic circulation. This observed relationship has prompted efforts to develop a fluid biopsy, with the goal of detecting these rare cells in patient peripheral blood as surrogate markers for metastatic disease as a partial replacement or supplement to tissue biopsies. Numerous platforms have been designed, yet these have generally failed to support a reliable fluid biopsy due to poor performance parameters such as low throughput, low purity of enriched antigen positive cells, and insufficiently low detection thresholds …