Medicine and Health Sciences Commons^™

Food Security Factors Affect Growth In Young Children In An Ecuadorian Indigenous Community, Whitney Jeannine Asher

Theses and Dissertations--Nutrition and Food Systems

Inadequate nutrition in preschool-aged children in an urban indigenous community outside of Santo Domingo, Ecuador has a negative impact on growth and development. Nutritional assessments have shown that children are underweight and that there are some effects of stunting and wasting in the population. This study was conducted to assess the extent of food security in this indigenous community in preparation for addressing two of the Millennium Development Goals for 2015: reducing the under-five child mortality rate by two-thirds and eradicating extreme poverty and hunger. An aim was to validate on-site assessment measures in this indigenous community regarding geographic circumstances, …

Impact Of The Healthy Hunger-Free Kids Act On Changes In The Phytochemical Content Of School Lunch Menus And Implications Of Science-Based Nutrition Education On Promoting Student Identification Of Foods High In Phytochemicals, Siddhi Lalit Shroff

Theses and Dissertations--Nutrition and Food Systems

Concern that youth do not have enough fruit and vegetable intake lead to two strategies implemented to influence intake in the school environment: the Healthy Hunger-Free Kids Act (HHFKA) and Fighting with Food: Battling Chemical Toxicity with Good Nutrition program (FF), which could influence phytochemical content and knowledge regarding phytochemicals, respectively. Individual food logs (n=468) were assessed upon completion of FF curriculum to determine whether students were able to correctly apply their nutrition knowledge regarding FF. Menus from one district were analyzed pre-HHFKA and post-HHFKA in elementary (n=156), middle (n=171), and high schools (n=171), for change in the frequency of …

The Synergistic Impact Of Income And Rurality On Timely Mammograms In A National Sample Of Women In The United States, Asri Mumpuni

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

Introduction. Breast cancer is the cancer of highest incidence among women in the U.S., making it a significant public health problem. Currently, the U.S. Preventive Services recommends biennial screening mammography for women ages 50-74. This study examined the associations between socioeconomic status and rurality on breast cancer screening behavior. Methods. Data for this study come from the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System Survey (BRFSS). Breast cancer screening behavior was dichotomized into those who did not meet screening mammogram recommendations (2 years or more) and those who met screening mammogram recommendations (within the …

Palliative Care: Evaluating And Designing Process Improvements For An Inpatient Consultative Program, Shawn M. Crouch

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

The purpose of this capstone project paper and study was to evaluate an inpatient palliative care consultation service and then make recommendations for improving the program. This paper includes a literature review related to palliative care models and best practices in structuring a successful inpatient palliative care service. The project included an analysis of how the program at one university based hospital measured success of the program and SWOT analysis based on interviews with members of the program’s team and leadership. Data sources used for the analysis included palliative care consultation utilization data from the identified hospital; other metrics used …

Alcohol Sale Status And Violent Deaths In Kentucky, Usa: 2005-2012, Hanan Abdulghafoor Khaleel

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

Alcohol is one of the major public health problems worldwide because of its association with many health and psychological problems. This study adds to the extant literature by examining the association between being a resident in a wet county and having an alcohol related violent death, an alcohol related suicide, or an alcohol related homicide victimization.

The first aim of this study is to determine whether residents of wet counties have a higher odds of alcohol related violent deaths than residents of dry/moist counties after adjusting for other confounding factors. The second aim is to determine whether residents of wet …

Inducible Depletion Of Satellite Cells In Adult, Sedentary Mice Impairs Muscle Regenerative Capacity Without Affecting Sarcopenia, Christopher S. Fry, Jonah D. Lee, Jyothi Mula, Tyler J. Kirby, Janna R. Jackson, Fujun Liu, Lin Yang, Christopher L. Mendias, Esther E. Dupont-Versteegden, John J. Mccarthy, Charlotte A. Peterson

Physical Therapy Faculty Publications

A key determinant of geriatric frailty is sarcopenia, the age-associated loss of skeletal muscle mass and strength. Although the etiology of sarcopenia is unknown, the correlation during aging between the loss of activity of satellite cells, which are endogenous muscle stem cells, and impaired muscle regenerative capacity has led to the hypothesis that the loss of satellite cell activity is also a cause of sarcopenia. We tested this hypothesis in male sedentary mice by experimentally depleting satellite cells in young adult animals to a degree sufficient to impair regeneration throughout the rest of their lives. A detailed analysis of multiple …

The National Cancer Institute’S Community Networks Program Initiative To Reduce Cancer Health Disparities: Outcomes And Lessons Learned, Kathryn L. Braun, Susan Stewart, Claudia Baquet, Lisa Berry-Bobovski, Daniel Blumenthal, Heather M. Brandt, Dedra S. Buchwald, Janice E. Campbell, Kathryn Coe, Leslie C. Cooper, Paula Espinoza, Ronda Henry-Tillman, Margaret Hargreaves, Aimee James, Judith Salmon Kaur, K. Viswanath, Grace X. Ma, Jeanne Mandelblatt, Cathy Meade, Amelie Ramirez, Isabel Scarinci, Sora Park Tanjasiri, Beti Thompson, Anissa I. Vines, Mark Dignan

Internal Medicine Faculty Publications

Background: We describe reach, partnerships, products, benefits, and lessons learned of the 25 Community Network Programs (CNPs) that applied community-based participatory research (CBPR) to reduce cancer health disparities.

Methods: Quantitative and qualitative data were abstracted from CNP final reports. Qualitative data were grouped by theme.

Results: Together, the 25 CNPs worked with more than 2,000 academic, clinical, community, government, faith-based, and other partners. They completed 211 needs assessments, leveraged funds for 328 research and service projects, trained 719 new investigators, educated almost 55,000 community members, and published 991 articles. Qualitative data illustrated how use of CBPR improved …

A Therapeutic Approach For Senile Dementias: Neuroangiogenesis, Charles T. Ambrose

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Alzheimer's disease (AD) and related senile dementias (SDs) represent a growing medical and economic crisis in this country. Apart from cautioning persons about risk factors, no practical, effective therapy is currently available. Much of the recent research in AD has been based on the amyloid cascade theory. Another approach assumes a vascular basis for SDs. This paper presents evidence from a score of studies that cerebral capillary density (CCD) declines during old age in animals and people as well as in AD. Neuroangiogenic (NAG) factors initiate and maintain capillaries in the brain. Thus a waning level of these factors and …

Outcomes Associated With Blood Component Transfusion In Adult Trauma Patients, Allison R. Jones

Theses and Dissertations--Nursing

The purpose of this dissertation was to evaluate outcomes associated with blood component (BC) transfusion in adult trauma patients. Specific aims were to: 1) explore the relationship between traumatic injury, hemorrhage, and BC transfusion, focusing on consequences of the component storage lesion through presentation of a conceptual model; 2) systematically review research literature comparing outcomes of massively transfused major trauma patients based on ratios of BCs received; 3) evaluating the relationship between type of blood transfusion trauma patients received (whole blood versus BCs) and mortality likelihood after controlling for demographic and clinical variables; 4) evaluating the relationship between volume and …

The Role Of Kentucky State-Supported Postsecondary Education In Creating A Healthier Citizenship, Julia K. Buchanan

Theses and Dissertations--Educational Leadership Studies

Citizens within the United States of America (USA) and the Commonwealth of Kentucky exhibit indicators of lessened health status in a variety of areas. Many chronic diseases and conditions are due to individual lifestyle behaviors, which can be modified through the implementation of dedicated health and wellness programming. Such programs, often housed within institutions of higher education, have the ability to impact many individuals including students, faculty, staff, and community members. This dissertation is a report of a mixed-methods study that begins to explore how state-supported postsecondary institutions may be able to impact individual behavior and thus, resulting health outcomes. …

Impaired Glucose Metabolism In The Absence Of Skeletal Muscle Brain And Muscle Arnt-Like-Protein 1 (Bmal1), Brianna D. Harfmann

Theses and Dissertations--Physiology

Metabolism is a critical physiological function that works to generate energy for cells, store substrates and maintain homoeostasis. Alterations in normal metabolism can have a severe effect on physiology, leading to metabolic disease. Skeletal muscle is a key metabolic tissue, taking up ~80% of postprandial glucose. Therefore it contributes considerably to glucose metabolism: glucose uptake, oxidation and homeostasis. To address the role of the skeletal muscle clock in insulin sensitivity and glucose tolerance, our lab generated an inducible skeletal muscle specific Bmal1^-/- mouse (iMSBmal1^-/-). 5 weeks post-recombination we observed impairment in both insulin- and AICAR-stimulated skeletal …

The Effect Of Music Therapy Interaction On Child And Parental Preoperative Anxiety In Parents Of Children Undergoing Day Surgery, Christopher R. Millett

Theses and Dissertations--Music

Young children who experience high levels preoperative anxiety often exhibit distress behaviors, experience more surgical complications, and are at a higher risk for developing a variety of negative postoperative consequences. A significant factor in pediatric preoperative anxiety is the level of anxiety present in their caregivers. Music therapy interventions addressing a variety of procedural outcomes have been met with success. The purpose of this study was to investigate the comparative effectiveness of two music therapy interventions on reducing preoperative anxiety in young pediatric surgical patients and their caregivers.

A total of 40 pediatric patient and caregiver dyads were included in …

Interdisciplinary Collaboration With Music Therapy During Routine Pediatric Dental Procedures, Austin S. Robinson

Theses and Dissertations--Music

The incorporation of integrative medicine into traditional treatment options has steadily increased during the past two decades. This has resulted in a change in the dynamics of interdisciplinary teams creating the need to better understand the roles and responsibilities of team members. The purpose of this study was to examine the perceptions of dental treatment team members regarding the role and responsibilities of music therapy during treatment.

A total of 10 participants were included in this study. Participants completed a pre-music therapy survey to establish prior knowledge, experience with, and perceptions of music therapy. Following an experiential intervention, participants completed …

Three Patients Needing High Doses Of Valproic Acid To Get Therapeutic Concentrations, James Jackson, Betsy Mccollum, Judy Ognibene, Francisco J. Diaz, Jose De Leon

Psychiatry Faculty Publications

Valproic acid (VPA) can autoinduce its own metabolism. Cases requiring VPA doses >4000 mg/day to obtain therapeutic plasma concentrations, such as these 3 cases, have never been published. Case 1 received VPA for seizures and schizophrenia and had >50 VPA concentrations in 4 years. A high dose of 5,250 mg/day of VPA concentrate was prescribed for years but this dose led to an intoxication when switched to the enterocoated divalproex sodium formulation, requiring a normal dose of 2000 mg/day. VPA metabolic capacity was significantly higher (t = -9.6; df = 6.3, p < 0.001) during the VPA concentrate therapy, possibly due to autoinduction in that formulation. Case 2 had VPA for schizoaffective psychosis with 10 VPA concentrations during an 8-week admission. To maintain a VPA level ≥50 μg/mL, VPA doses increased from 1500 …

Coffee: A Selected Overview Of Beneficial Or Harmful Effects On The Cardiovascular System?, Thomas F. Whayne Jr.

Internal Medicine Faculty Publications

With a history that began in 800 A.D., coffee is the most popular drink known and as a result, the issues regarding its physiologic effects deserve attention. Maintaining alertness is a well-known benefit and in addition, the cardiovascular (CV) effects of the active compounds, which include polyphenols and caffeine, must be considered. Genetics are relevant and where slow caffeine metabolism is inherent, the risk of nonfatal myocardial (MI) has been shown to be increased. Overall risk for coronary heart disease (CHD) is not supported and unless there is excessive intake, congestive heart failure (CHF) is not adversely affected; in moderation, …

Designing For Dissemination: Lessons In Message Design From "1-2-3 Pap", Elisia L. Cohen, Katharine J. Head, Margaret J. Mcgladrey, Anna G. Hoover, Robin C. Vanderpool, Colleen Bridger, Angela Carman, Richard A. Crosby, Elaine Darling, Mary Tucker-Mclaughlin, Nancy Winterbauer

Communication Faculty Publications

Despite a large number of evidence-based health communication interventions tested in private, public, and community health settings, there is a dearth of research on successful secondary dissemination of these interventions to other audiences. This article presents the case study of "1-2-3 Pap," a health communication intervention to improve human papillomavirus (HPV) vaccination uptake and Pap testing outcomes in Eastern Kentucky, and explores strategies used to disseminate this intervention to other populations in Kentucky, North Carolina, and West Virginia. Through this dissemination project, we identified several health communication intervention design considerations that facilitated our successful dissemination to these other audiences; these …

Factors Facilitating Constructive Coping With Stress, Kamilla Bargiel-Matusiewicz, Hatim A. Omar

Pediatrics Faculty Publications

This review focuses on coping with stress, with particular emphasis on mechanisms facilitating constructive coping with stress. An important area of contemporary research is the attempt to identify factors that make it possible to stay mentally healthy or preventing the weakening of the cognitive and social functioning. The currently prevailing approach to stress is the relational approach. According to this approach, the criterion for the occurrence of stress is the cognitive assessment of the situation made by an individual. This review presents the most recent proposals concerning the analysis of specific methods of coping with stress, in particular from the …

Revisiting Menstrual Bleeding Patterns In Adolescents Using Etonogestrel (Eng) Implant, Anna Iddings, Hatim A. Omar

Pediatrics Faculty Publications

Etonogestrel (ENG) implant is an effective method of contraception. The implant is designed to provide contraceptive efficacy for three years with a relatively quick return of fertility upon its removal. Dysfunctional uterine bleeding (DUB) is a common side effect of long acting progestins and is often the reason patients state for removal or discontinuation. A retrospective chart analysis was completed on 292 patients who chose to be on the ENG implant. Age of patients ranged from 10-29 years of age with the average age at implant being 17 years +/- 3 years. Patients retained implant for 1-68 months with the …

Cyberbullying In Adolescents: The Prevalence Of Mental Disorders And Suicidal Behavior, Elizabeth L. Mirsky, Hatim A. Omar

Pediatrics Faculty Publications

This paper defines the phenomena of cyberbullying in relation to traditional bullying, along with its negative consequences on adolescents in modern society. The reasons for the highly destructive effects of cyberbullying are given along with information about psychological instability resulting from the occurrence of cyberbullying. The correlation of cyberbullying with suicidal thoughts and behaviors is also discussed. Finally, some prevention techniques are listed in an attempt to lower the prevalence of cyberbullying.

Syphilis: The Forgotten Sexually Transmitted Disease. A Brief Case Report, Amy Burnett, Hatim A. Omar

Pediatrics Faculty Publications

Syphilis has declined significantly over the last 30 years. Due to that success, many physicians no longer have the skills to recognize its symptoms. We present a case of syphilis as a demonstration of this fact.

Hiv And Minority Youth, Mandakini Sadhir, Hatim A. Omar

Pediatrics Faculty Publications

Human Immunodeficiency virus (HIV) infection is a major public health problem with the burden of disease increasing in adolescents and young adults particularly among black males and males who have sex with males (MSM).

Paper I: Stress In Adolescents, Stephanie Stockburger, Hatim A. Omar

Pediatrics Faculty Publications

It is well known that adolescents experience stress. In this article, sources of adolescent stress will be discussed as well as the physiological effects of stress on the body. Stress disorders will also be briefly reviewed. Mainly, research on stress management strategies that have been evaluated in adolescents will be presented. Many studies have a small number of participants and lack control groups. Therefore, there is a need for ongoing research in this important area.

Part Ii - Stress And Stress Management Strategies In Adolescents, Stephanie Stockburger, Hatim A. Omar

Pediatrics Faculty Publications

It is well known that adolescents experience stress. In this article, sources of adolescent stress will be discussed as well as the physiological effects of stress on the body. Stress disorders will also be briefly reviewed. Mainly, research on stress management strategies that have been evaluated in adolescents will be presented. Many studies have a small number of participants and lack control groups. Therefore, there is a need for ongoing research in this important area.

The Importance Of Comprehensive Sexuality Education In Adolescents, Sarah Lebrun, Hatim A. Omar

Pediatrics Faculty Publications

No abstract provided.

Female Athlete Triad Review, Hannah Harrison, Hatim A. Omar

Pediatrics Faculty Publications

This article defines the female athlete triad and discusses long-term consequences for adolescents and women symptoms related to the triad. The pillars of the female athlete triad consist of menstruation disruption, decreased bone mineral density, and disordered eating (energy availability). We will discuss the problems that can arise from each of the three pillars of the female athlete triad and the relationships among them. There are different treatments for the triad based on the needs of the individual and new treatments are being researched. Finally, the need for more informed coaches, parents, and medical professionals is discussed.

Effective Youth Suicide Prevention: Evidence From Kentucky, Dessi Slavova, Hatim A. Omar

Pediatrics Faculty Publications

In 2013, Suicide was the second leading cause of death among U.S. young adolescents (15-19 years of age), accounting for 18.4% of all deaths in this age group. According to a nationally representative study on the lifetime prevalence of adolescent suicidal behaviors, 12.1% of U.S. adolescents experience suicidal ideation, 4.0% develop a plan, and 4.1% attempt suicide. The same study estimated that approximately 60% of young people with a suicide plan will attempt suicide, and most of the adolescents who subsequently make an attempt do so within the first year after the onset of ideation.

These findings support the importance …

Children With Asthma: What About The Quality Of Life Of Their Parents?, Anna Trzcieniecka-Green, Kamilla Bargiel-Matusiewicz, Agnieszka Wilczyńska, Hatim A. Omar

Pediatrics Faculty Publications

An increased frequency of asthma in children has been lately observed. The course of asthma depends not only on treatment. but also on the actions taken by the parents of a sick child. Design: A non-experimental cross-sectional design. Methods: In this study the Pediatric Asthma Quality of Life Questionnaire (PACQLQ) and Satisfaction with Life Scale (SWLS) were administered to 60 parents of children with :asthma. Two groups of parents were compared. The first group consisted of parents of children who had been diagnosed with asthma less than three months before the beginning of the study. The second group consisted of …

Starting Off, Hatim A. Omar

Pediatrics Faculty Publications

This book is really a reflection of the past 15 years of work with teens and suicide prevention in the state of Kentucky. The work to establish the "Stop Youth Suicide Campaign (SYS)" has resulted in contact with many young adults and we have found that the most important thing for all of them, was finding a caring person they trust and can talk to. Because of the constant need, the SYS went from a goal of one year awareness campaign to a major community resource, to work with the state and local governments and state legislators to add as …

Disability And Suicide, Divya Nagraj, Hatim A. Omar

Pediatrics Faculty Publications

We provide a systematic review of suicide among adolescents with physical disabilities, intellectual disability and learning disability. A search was performed of English articles published prior to December 2014 in the PubMed database for studies examining suicide, suicidal behavior and suicidal ideation among adolescents with and without varied disabilities. Nine studies were retrieved, of which two studies examined adolescent populations with physical disabilities, three looked at suicide in adolescents with intellectual disability and four studies examined adolescents with learning disabilities. There were consistent results to prove that these adolescents with special needs had an increased tendency to commit suicide and …

Self-Cutting And Suicide In Adolescents, Donald E. Greydanus, Hatim A. Omar

Pediatrics Faculty Publications

Deliberate self-harm (DSH) is a common and typically secret phenomenon in adolescents, especially females that involves two main features—self-derogation and negative emotionality. Causes of non-suicidal self-injury include attempts to get help from professionals, express disgust or self-anger, resist suicidal thoughts, and correct episodes of dissociation. DSH is associated with eating disorders and alcohol abuse, as well as other illict drug abuse. Fortunately, most self-cutters are not at high risk for eventual suicide; however, all those with DSH histories should be carefully assessed for suicide as well as offered comprehensive management. Programs for prevention of suicide should be implemented for adolescents …