Medicine and Health Sciences Commons^™

Pediatric Obesity: Taking Advantage Of Well-Child Visits For Early Identification, James E. Gelement

DNP Projects

Background: Pediatric obesity has reached epidemic levels in the United States and the burden of early identification and prevention lies with Primary Care Providers. With this burden comes the responsibility of increased documentation in order for patients to obtain the appropriate counseling, treatment, and referrals.

Objective: The objective of this study is to identify missed opportunities to identify pediatric patients that meet the criteria for overweight or obesity during well-child visits within a primary care practice.

Method: A retrospective chart review of 100 randomly selected patients born between 9/1/2001 and 9/1/2010 that have received a well-child visit between 1/1/2010 and …

Drug Overdose Deaths, Hospitalizations, And Emergency Department Visits In Kentucky, 2000‐2012, Svetla Slavova, Terry L. Bunn, Joshua W. Lambert

Kentucky Injury Prevention and Research Center Special Report

This report presents drug overdose morbidity and mortality data for Kentucky residents, using multiple data sources:

• Kentucky Death Certificate Files, Kentucky Office of Vital Statistics, 2000‐2012 (data captured as of October 21, 2013). The 2009‐2012 files are provisional and subject to change.
• Kentucky Inpatient Hospitalization (IH) Discharge Files, Cabinet for Health and Family Services, Office of Health Policy, 2000‐2012 (data for 2010‐2012 are provisional and subject to change).
• Kentucky Emergency Department (ED) Discharge Files, Cabinet for Health and Family Services, Office of Health Policy, 2008‐2012 (data for 2010‐2012 are provisional and subject to change).

Assessing Provider Adherence To An Emergency Contraception Guideline In Reproductive Age Women, Amber E. Davis

DNP Projects

Purpose: To determine current provider adherence to the 2010 ACOG Emergency Contraception (EC) guidelines, specifically by assessing provider EC counseling with patients at well-woman annual exam visits or during contraceptive counseling visits. A second aim of this study is to identify provider facilitators and barriers of EC discussion with patients.

Methods: Using a retrospective design, 90 medical records of patients presenting to a university clinic within the previous year were reviewed for the discussion of EC during annual exams or contraceptive counseling. Forty-five medical records were reviewed prior to implementation of the Ambulatory Electronic Health Record (AEHR) and forty-five medical …

Role Of The "Tobacco Free Teens" Mobile Application In Adolescent Smoking, Juawanna L. Schuller

DNP Projects

Adolescent tobacco use rates have plateaued. Tobacco use education is not mandatory in all states, yet schools remain a good opportunity to reach this population. School nurses should be able to identify components of effective tobacco use prevention education programs and learn to overcome barriers to implementation of these programs. The "Tobacco Free Teens" mobile application is a novel tool that may decrease adolescent tobacco use rates. A pilot study found that the Tobacco Free Teens mobile application was satisfactory to most participants but appealed to girls more than boys. Further research is needed to determine the effectiveness of this …

Automated Reminders To Promote Radon Testing In A Lung Cancer Case Control Study, Stacey Slone, Susanne M. Arnold, Lara Sutherland, Heather Robertson, Frances J. Feltner, Joshua Crase, Megan Combs, Ellen J. Hahn

Center of Excellence in Rural Health Presentations

One of the four pilot projects of the Lung Cancer Initiative sponsored by the Department of Defense measures radon levels in the participants homes. Radon exposure is the second leading cause of Lung Cancer. The case-control study has a targeted accrual of 1800 with a case-control ratio of 1:4. The long-term radon kits remain in the home for 90 days and the participants are asked to mail the test kit to the company for analysis. In order to maximize the test kit return rate, reminder calls to the participants occurred 90 days after the home visit.

The Role Of Exercise In Polychlorinated Biphenyl Induced Cardiovascular Disease, Margaret O'Bryan Murphy

Theses and Dissertations--Nutritional Sciences

Cardiovascular disease remains the leading cause of death in Western societies. Endothelial dysfunction is one of the initiating steps in the development of atherosclerosis. While there is a strong correlation with a person’s genetics, lifestyle factors including smoking, physical activity, and diet can significantly increase a person’s susceptibility to the development of atherosclerosis. In addition to these lifestyle factors, there is a strong body of evidence linking exposure to environmental pollutants including persistent organic pollutants such as polychlorinated biphenyls to increased cardiovascular disease and mortality. It has been well-established that exercise protects against cardiovascular disease, but whether exercise can modulate …

The Role Of Scavenger Receptor Class B Type I-Regulated Inducible Glucocorticoids In Sepsis, Junting Ai

Theses and Dissertations--Nutritional Sciences

Sepsis claims over 215,000 lives in the US annually. Inducible glucocorticoids (iGC) is produced during sepsis. However, the precise effects of iGC in sepsis remain unclear due to a lack of appropriate animal models. Glucocorticoid (GC) insufficiency is associated with a marked increase in mortality and occurs in 60% of severe septic patients. Yet the conclusion of GC therapy on septic patients is still controversial.

Scavenger receptor class B type I (SR-BI) in the adrenal mediates the selective uptake of cholesteryl ester from lipoproteins for GC synthesis. SR-BI-/- mice completely lack iGC during sepsis and are highly susceptible to septic …

The Role Of Angiotensinogen In Atherosclerosis And Obesity, Congqing Wu

Theses and Dissertations--Nutritional Sciences

Angiotensinogen is the only known precursor in the renin-angiotensin system, a hormonal system best known as an essential regulator of blood pressure and fluid homeostasis. Angiotensinogen is sequentially cleaved by renin and angiotensin- converting enzyme to generate angiotensin II. As the major effector peptide, angiotensin II mainly function through angiotensin type 1 receptor.

Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and more recently renin inhibitors are widely known as the 3 classic renin-angiotensin system inhibitory drugs against hypertension and atherosclerosis. Here, we developed an array of regents to explore the effects of angiotensinogen inhibition. First, we demonstrated that genetic deficiency of …

Firesetting And Maltreatment, Amy L. Burnett, Hatim A. Omar

Pediatrics Faculty Publications

In this chapter we try to determine if a link exists between firesetting offenders and a past history of maltreatment. A literature review was performed using research from various studies and populations. Firesetting is a significant problem that affects the world's youth today. Even though there is substantial loss of property and life from juvenile firesetters, there is not a great deal of research to provide insight into early identification of those at risk. In the literature review performed, 6 of 7 studies found a link with maltreatment and firesetting behaviors. There does seem to be a correlation between the …

Children, Violence And Bullying, Joav Merrick, Isack Kandel, Hatim A. Omar

Pediatrics Faculty Publications

Adolescent violence is a very visible phenomenon in our modern society, where you just have to open the newspaper or the television and you find yourself right in the middle of it. In order to understand the scope of the problem, we need to look at the epidemiology of global violence. Each year, more than 1.6 million people worldwide lose their lives to violence and for every person who dies as a result of violence, many more are injured and suffer from a range of physical, sexual, reproductive and mental health problems. Violence places a massive burden on national economies …

Adolescent Violence Prevention, Hatim A. Omar

Pediatrics Faculty Publications

Violence in adolescence has seen an increase since the 1990s with dramatic statistics on violent death and risk behaviors. School violence has been focused upon by a huge media coverage of especially violent cases that could have had some endemic consequences worldwide. We present a case of a 14 year old white male with change in school behavior, strategies for the case investigation, its results and long term prevention. Other research has shown that preventive measures during pregnancy, infancy and childhood can prevent adolescent and adult delinquency.

Prevention: Sexual Violence Against Adolescent And Young Adult Women, Kimberly K. Mcclanahan, Marlene B. Huff, Hatim A. Omar, Joav Merrick

Pediatrics Faculty Publications

No abstract provided.

A Grassroots Program For Youth Suicide Prevention, Stephanie Stockburger, Hatim A. Omar

Pediatrics Faculty Publications

Suicide is a major public health problem. It affects people of all ages. Youth, in particular, have a disturbingly high suicide rate. Suicide is the third leading cause of death for young people between the ages of 10 and 24 (1). Approximately 4600 young people die each year from a suicide attempt (1). The most common methods used in suicides are firearms (45%), suffocation (which may be in the form of hanging) (40%), and poisoning (8%) (1). However, more young people survive suicide attempts than actually die from the attempt. A national survey of youth in both private and public …

Pharmacy Law Brief: Implications Of Being A Specialist, Joseph L. Fink Iii

Pharmacy Practice and Science Faculty Publications

No abstract provided.

Let’S Play: Understanding The Role And Significance Of Digital Gaming In Old Age, Julie A. Skalsky Brown

Theses and Dissertations--Gerontology

Despite a marked increase in the use of digital games among older persons, there is insufficient research that provides insight into the gaming experiences of this population. A major demographic shift within the senior gaming market has ushered in a new perspective on the use of digital games as a tool for physical and cognitive health, and improved socialization. It is proposed that individual notions of play, which are developed over the life course, influence digital game play engagement and interaction preferences, and contribute to well-being. This study explored how self-perceptions of play over the course of the senior gamer’s …

Plagiarism Of Ideas. Benjamin Rush And Charles Caldwell--A Student-Mentor Dispute, Charles T. Ambrose

Microbiology, Immunology, and Molecular Genetics Faculty Publications

No abstract provided.

Study Abroad Opportunities For Dietetics And Human Nutrition Students: Expectations, Benefits And Barriers, Kailey Marie Cunningham

Theses and Dissertations--Nutrition and Food Systems

This study analyzed the perceptions of University of Kentucky Dietetic and Human Nutrition students as they relate to the benefits and barriers of study abroad educational opportunities. The final sample consisted of 164 participants, with 18.9% (n=31) in the Coordinated Program in Dietetics (CP), 32.3% (n=53) in the Didactic Program in Dietetics (DPD), 42.7% (n=70) in the Human Nutrition (HN) program and 5.5% (n=9) who identified their program as ‘other’. The primary barriers to participation in study abroad were cost and problems fitting education abroad into the current program of study. The primary benefits were identified as dietary and health …

The Human–Hookworm Assemblage: Contingency And The Practice Of Helminthic Therapy, Sophia Anne Strosberg

Theses and Dissertations--Geography

Through a qualitative analysis of the use of intestinal parasites for treating immune system disorders, this research illustrates how contingency emerges in the context of the human relationship to hookworms. The affect of the human–nonhuman relationship is an important part of understanding the direction of evolutionary medicine today, and has implications for the politics of biological health innovations. The shift from the bad parasite to a parasite that at least sometimes heals, discursively and materially, has opened new spaces for patients to change the way they relate to medical knowledge, medical professionals, and pharmaceutical companies. Hookworms are banned by the …

Pretreatment Of Scenedesmus Sp. Biomass As A Potential Anaerobic Digestion Substrate, Xinyi E, Czarena Crofcheck

Biosystems and Agricultural Engineering Faculty Publications

Algal biomass can be a potential substrate for anaerobic digestion. However, raw algae cells show a resistance to biological degradation, resulting in a slower methane production rate. Varying thermal and chemical pretreatments of algal biomass were investigated in an attempt to increase soluble organic matter (SOM) yield, which would result in enhanced methane production during subsequent anaerobic digestion. Scenedesmus sp. was harvested using three different procedures: with flocculation, with flocculation and drying, and without flocculation or drying. For all pretreatments and algae types, fluorescence micrographs were obtained to visually confirm the degradation of the algal cell walls. A complete 2 …

Associations Of Maternal Socio-Demographic And Psychosocial Characteristics With Alcohol Use During Pregnancy, Nneoma Adaobi Ilogu

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

Alcohol is reported to be one of the most used legal substances among women of reproductive age, and its use during pregnancy is one of the most preventable causes of birth defects and developmental disabilities.1 Due to its teratogenic nature, alcohol use during pregnancy has been associated with a condition referred to as Fetal Alcohol Spectrum Disorders (FASD).2 This comprises of a wide spectrum of disorders such as Fetal Alcohol Syndrome (FAS), alcohol-related birth defects, and alcohol-related neurodevelopmental disorders, which are estimated to affect 1% of all births in the United States and can be prevented through the modification of …

Are There Benefits Of Smoking Reduction During Pregnancy? Smoking Status Of Pregnant Women And The Effect On Pre-Term Delivery, Kelli Ann Mclane

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

Premature delivery is defined as a baby born before thirty-­‐seven completed weeks of pregnancy. Premature delivery can result in a longer hospital stay after delivery compared to babies born at full-­‐term.1 Babies born before 37 gestational weeks also have a greater potential for health problems such as acute respiratory, gastrointestinal, immunologic, central nervous system, hearing, and vision problems, as well as longer-­‐term motor, cognitive, visual, hearing, behavioral, social-­‐emotional, health, and growth problems.2 Premature births can impact at the individual level and at a societal level. “The birth of a preterm infant can bring considerable emotional and economic costs to families …

Factors Affecting School Health Scores: Wellsat Scores, School Policy, And The School Environment, Alicia Baker

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

A recent trend in school health intervention has been through policy creation and development. Studies have shown that changes in school health policy can improve student health behaviors, particularly in physical activity and nutrition. This study looked at how potential factors could affect the scores of a school policy assessment tool called the Wellness School Assessment Tool (WellSAT). Using a combination of t-tests, chi-square tests, and logistic regression, schools’ strength and comprehensiveness nutrition scores from the WellSAT were analyzed when compared to Free and Reduced Lunch Rates, type of school, and whether schools had separate policies from their school district. …

Effects Of Locality And Risk Of Late Stage Breast Cancer Diagnosis In Kentucky Females, 2001-2011, Michael Jacob Sither

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

Breast cancer survival is heavily dependent on stage at diagnosis. Recent evidence supports rural women are more likely than urban women to be diagnosed with advanced stage disease but historically these findings have been mixed when investigated at the state level. Cancer surveillance in the Appalachian region suggests Kentucky females are at significantly greater risk of premature breast cancer mortality due to consistently lower prevalence of screening mammography utilization. In the literature, disparities in breast cancer outcomes have been largely explained by population demographics, areabased measures of socioeconomic deprivation, shortages of referring providers as well as differences in spatial access …

Evaluating Oral Health Trends In Kentucky, 2006-2012, Briana Michelle Forsythe

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

According to the former US Surgeon General, C. Everett Koop, “You’re not healthy without good oral health.” Poor oral health, comprising of the presence of caries and/or periodontal disease, can lead to edentulism, which in turn can yield poor physical health, inability to communicate properly, poor mental health, and a lesser quality of life. In Kentucky, over one quarter of the adult population has lost six or more teeth due to decay or gum disease, a figure 10% higher than the national average. Objectives: The purpose of this study was to examine: a) Kentucky’s Statewide Oral Health Strategic Plan, implemented …

Factors Influencing Differential Oral Health Care Use Between Hispanics And Non-Hispanic Whites In The U.S., Nathalie Astudillo

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

Oral health is often considered merely the absence of disease. However, oral health involves much more. Good oral health facilitates very basic functions like eating and speaking; a healthy smile is also associated with good self-esteem and productivity.1 Most oral health diseases are largely preventable. Despite this, a large portion of the population in the United States still suffer from untreated dental decay.2 Poor oral health has a direct effect on systemic health, quality of nutrition, digestion, phonetics, selfimage and self-esteem.5 Whether considered individually or combined, each of these factors has a direct impact on the quality of life of …

Play In Children With Motor Disabilities, Suzanne Martin

Theses and Dissertations--Rehabilitation Sciences

The purpose of this research was to explore and describe the relationship among the child, family, home environment, and pretend play of children with motor disabilities. The environment is a powerful force in early child development. This research is based on Bronfennbrenner’s ecological theory of development and the ubiquitous role of play in all domains of development. Children with motor disabilities may lack exploration of the environment and as a consequence demonstrate deficits in play. Play was measured in 32 children with motor disabilities aged 24.8 to 61.3 months with a mean age of 33.7 (SD 9.3) months. Children demonstrated …

Injuries Among Miners In Kentucky During 2010-2012 From Workers Compensation Data, Evelyn Thomas

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

Introduction: Coal miners in Kentucky have higher rates of injury morbidity and mortality than national rates. In order to understand better what is happening in this area, we not only analyzed the injuries and deaths, but also identified common characteristics between these nonfatal and fatal injuries. The objectives of this study were to 1) Identify injuries among coal miners in Kentucky; 2) Determine if there are any other risk factors for injuries other than working in a mine; and 3) Determine the different health effects on coal mine workers. Methods: Data from Kentucky Workers’ Compensation First Reports of Injuries and …

Influence Of Marianismo On Colorectal Cancer Screening Behavior Among Hispanic Women In The United States, Robin Thompson

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

Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the second leading cause of cancer death in the United States (U.S).1 Although early detection and treatment can reduce CRC-related morbidity and mortality, almost twothirds of patients are diagnosed with advanced stage disease indicating non-adherence to recommended screening guidelines.1 Indeed, less than half of individuals over 50 years of age get screened at recommended intervals.2 More specifically, lower rates of CRC screening exist among these groups: those identifying as being of Hispanic origin, the uninsured, disabled individuals, and women.3 In a 2011 report from the National Center on Health …

An Exploration Of Empowerment, Sexual Violence, And Hiv Among Indian Women, Brigid Kyung-Hwa Cecil

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

Empowerment plays a major role in sexual violence and HIV among women worldwide. Findings on empowerment in relation to domestic violence or HIV are scarce and are conflicting. The purpose of this study was to examine the relationship between empowerment and HIV status by means of sexual violence, and to compare this relationship between previously married women (N = 2,658) and currently married women (N = 37,539) living in India. The Baron and Kenny mediated regression model was used, involving simple logistic and multiple logistic regression, drawing from the National Family Health Survey 2005-2006 (NFHS-3). Sexual violence was not found …

Association Of Hiv Testing, Educational Attainment, And Age Among Black And Non-Black Men, Ashley N. Martell

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

Human Immunodeficiency Virus (HIV) infection can lead to a chronic condition, Acquired Immunodeficiency Syndrome (AIDS), but can be well managed with a combination of medications, treatments, and remedies.1 The emergence of HIV in the United States in 1981 created an atmosphere unlike any other at that time. Overtime, the science community has worked diligently to combat this disease through research, practice, and intervention. Although many efforts have been put forth over the past thirty years, millions of Americans still remain infected with HIV.2 Among those who are infected with HIV/AIDS we see disproportionate rates among specific races and gender. Research …