Medicine and Health Sciences Commons^™

A Post-Dsm-Iii Wake-Up Call To European Psychiatry, Jose De Leon

Psychiatry Faculty Publications

No abstract provided.

Are Major Repeater Patients Addicted To Suicidal Behavior?, Hilario Blasco-Fontecilla, Paula Artieda-Urrutia, Nuria Berenguer-Elias, Juan Manuel Garcia-Vega, Monica Fernandez-Rodriguez, Cesar Rodriguez-Lomas, Isabel Gonzalez-Villalobos, Luis Iruela-Cuadrado, Jose De Leon

Psychiatry Faculty Publications

The literature provides support for the hypothesis that some major repeaters (individuals with >=5 lifetime suicide attempts) are addicted to suicidal behavior (SB). This study explores whether major repeaters are addicted to SB or not using 7 criteria: tolerance (Criterion 1), withdrawal (Criterion 2), loss of control (Criterion 3), problems in quitting/cutting down (Criterion 4), much time spent using (Criterion 5), substantial reduction in activities (Criterion 6), and adverse physiological/physical consequences (Criterion 7). Total dependence on SB was indicated by the presence of 3 or more of the 7 criteria in the last 12 months. This cross-sectional study at Puerta …

Right Upper-Quadrant Pain In A Patient With Drug Abuse, Secondary Syphilis And Occult Hepatitis B Virus, Cory M. Fielding, Paul Angulo

Internal Medicine Faculty Publications

OBJECTIVE: To describe the etiology of hepatitis and identify occult hepatitis B virus (HBV) infection.

CLINICAL PRESENTATION AND INTERVENTION: A 40-year-old man presented with severe abdominal pain and jaundice, a history of acute HBV infection that had cleared as well as the use of acetaminophen, methamphetamine, buprenorphine and marijuana. He admitted to having had unprotected sex with multiple partners of both genders. A thorough skin examination revealed papulosquamous lesions on his penis, scrotum, upper and lower extremities and feet. Transaminases and bilirubin were elevated. His rapid plasma reagin was reactive, and hepatitis serologies showed occult HBV. Liver biopsy showed severe …

Children, Adolescents And Firesetting, Joav Merrick, Carrie Howell Bowling, Hatim A. Omar

Pediatrics Faculty Publications

The research of firesetting has been conducted in different ways and lacks a coherent, consistent and comprehensive set of empirical findings. A recent review concluded that despite a number of risk factors being repeatedly identified, an understanding of the etiology behind firesetting behavior and potential developmental trajectories remains theoretically rather than empirically based. Existing theories do not take sufficient account of the complexities of firesetting behavior and there is not yet a typology and accompanying assessment that has undergone thorough empirical testing and is of significant clinical utility. Due to the relationship between firesetting and antisocial behavior there is a …

Firesetting, Sexual Abuse And Long-Term Consequences, Lesley Davidson, Hatim A. Omar

Pediatrics Faculty Publications

In this chapter we summarize the limited studies on post-pubertal consequences of female childhood sexual abuse that includes both psychological distress and physiological stress. The characteristics of sexual abuse are discussed and determined to play a major role in the degree of trauma experienced and in the later effects. The concept of hormones and how disruptions in various endocrine systems can affect the development of these females are examined, especially during the pubertal period. Outcomes of interest included competence, in terms of cognitive, social, self-esteem, and locus of control, and psychopathology including depression, anxiety, dissociation, and hypersexuality. Direct physical results …

Firesetting Behavior And Psychiatric Disorders, Stephanie Stockburger, Hatim A. Omar

Pediatrics Faculty Publications

Firesetting behavior results in serious damage to lives and property every year. Firesetting has been linked to a number of comorbid psychiatric disorders including depression, substance abuse, conduct disorder, antisocial personality disorder, obsessive compulsive disorder, psychotic disorder, schizoid personality disorder, and schizophrenia. Psychiatric disorders differ by gender. In addition, juvenile firesetters have history of a separate set of psychiatric comorbidities. The strong correlation between psychiatric comorbidities and firesetting behavior illustrates the need for fire service and mental health collaboration.

Self-Reported Juvenile Firesetting, Carrie Howell Bowling, Hatim A. Omar

Pediatrics Faculty Publications

In this chapter we address gaps in existing research by examining the relationship between academic performance and attention problems with juvenile firesetting. Two datasets from the Achenbach System for Empirically Based Assessment (ASEBA) were used. The Factor Analysis Dataset (N = 975) was utilized and results indicated that adolescents who report lower academic performance are more likely to set fires. Additionally, adolescents who report a poor attitude toward school are even more likely to set fires. Logistic regressions were run to determine if attention problems predicted firesetting and the findings indicated that attention problems are predictive of self-reported firesetting. The …

Adolescent Bereavement, Leslie Robin, Hatim A. Omar

Pediatrics Faculty Publications

Depending on cognitive and emotional development, an adolescent may grieve very differently than a child or an adult. While mature enough to understand death's irreversibility, adolescents may not fully comprehend the enduring consequences of a loved one's death. As the desire to separate from their families and forge new intimate relationships with peers assumes increasing priority, adolescents can seem egocentric in their reaction to death, a response which often frustrates and perplexes adults. Because volatile behavior is characteristic of adolescence, health providers struggle to differentiate between normal and complicated bereavement. Here we review the commonly-accepted characteristics of normal and complicated …

Adolescent Health Issues, Joav Merrick, Ariel Tenenbaum, Hatim A. Omar

Pediatrics Faculty Publications

No abstract provided.

United States: Sexual Behavior In Association With Human Papilloma Virus Vaccination In Young Girls, Wafa R.R. Al Romaih, Said Shahtahmasebi, Hatim A. Omar

Pediatrics Faculty Publications

The first human Papilloma virus (HPV) vaccine was approved in the United States in 2006 with the potential to reduce cervical cancer and genital warts. Since then, its efficacy in preventing HPV-related cancers in both males and females has been promising. Despite CDC recommendations, opponents of the vaccine assert that vaccinating preadolescents and adolescents will increase their sexual activity, as well as overtly condone risky sexual behavior. We analyzed clinic data of 499 adolescents with a mean age of 16 years to explore whether vaccination led to change in sexual behavior after one year. Our results showed no statistically significant …

Dating Violence In Adolescence, Anuja Bandyopadhyay, Amit M. Deokar, Hatim A. Omar

Pediatrics Faculty Publications

Adolescent dating violence is a health and social problem, worldwide. The objective of this chapter was to identify the risk factors and consequences of dating violence, assess the prevention measures taken to increase awareness regarding it and provide an overview of the screening and interventional tools used to support the teens involved in dating violence. Methods: A review of the literature, published in the last 29 years, was conducted and the content was clinically analyzed. Conclusions: There is an increasing trend of dating violence in a younger population. Consistent definitions, comprehensive assessment tools and focused screening are required to assess …

A Grassroots Program For Youth Suicide Prevention: An Overview Of Participant Comments Following Stop Youth Suicide Conference, Stephanie Stockburger, Hatim A. Omar

Pediatrics Faculty Publications

No abstract provided.

Disability And Women's Health, Stephanie Stockburger, Hatim A. Omar

Pediatrics Faculty Publications

Children, adolescents, and women with disabilities experience the same sexual development, pubertal changes, concerns, and desire to reproduce as their typically developing counterparts. However, society has tended to stigmatize women with disabilities as "asexual" and ignore this aspect of their health care. These women are less likely to receive gynecological exams, contraception, and evaluation of sexual dysfunction. Unfortunately, having a disability places women at risk for sexual exploitation and abuse as well as sexually transmitted infections. Therefore, reproductive health care for these women is imperative. A number of barriers to receiving reproductive care exist. However, with proper education and knowledge …

Family Environmental Health And Teen Outcomes, Lesley Davidson, Alissa Briggs, Hatim A. Omar

Pediatrics Faculty Publications

Understanding the impact of family dynamics on health has become an environmental health priority in the field of adolescent medicine. Family dynamics are much more complex than they were 60 years ago and so are behavioral outcomes. This transformation in the American family has led towards a large array of adolescent living situations. Rural Kentucky is a prime example of an area with a high rate of nontraditional family composition. Poor family dynamics may be associated with increased rates of high risk behaviors among teenagers. Among these behaviors are drug use, sexual activity, and depression. In this study, we evaluated …

Academic Predictors And Characteristics Of Self-Reported Juvenile Firesetting, Carrie Howell Bowling, Hatim A. Omar

Pediatrics Faculty Publications

The main purpose of this study was to address gaps in existing research by examining the relationship between academic performance and attention problems with juvenile firesetting. Two datasets from the Achenbach System for Empirically Based Assessment (ASEBA) were used. The Factor Analysis Dataset (N = 975) was utilized and results indicated that adolescents who report lower academic performance are more likely to set fires. Additionally, adolescents who report a poor attitude toward school are even more likely to set fires. Logistic regressions were run to determine if attention problems predicted firesetting and the findings indicated that attention problems are predictive …

Adolescence And Sexuality, Joav Merrick, Ariel Tenenbaum, Hatim A. Omar

Pediatrics Faculty Publications

No abstract provided.

Spinocerebellar Ataxia 7: A Report Of Unaffected Siblings Who Married Into Different Sca 7 Families, Fariha Zaheer, Dominic B. Fee

Neurology Faculty Publications

Two families with spinocerebellar ataxia type 7 are presented. Although there are affected cousins, it is not the sibling parents that transmitted the mutation. It is assumed that the affected families share a common ancestor.

Mrp1: A Target For Hematopoietic Stem Cell Diseases, Cassandra Reiling

Theses and Dissertations--Toxicology and Cancer Biology

Multidrug resistance-associated protein 1 (MRP1) is a member of the adenosine 5’-triphosphate (ATP)-binding cassette (ABC) transporters. MRP1 actively effluxes a variety of endogenous and exogenous substrates from cells, ultimately, working to remove these compounds from the body. MRP1 was initially discovered based on its ability to confer resistance against a variety of chemotherapeutics when overexpressed in cancer cells lines. MRP1 function is important for a number of physiological processes, including regulating cellular and extracellular levels of the anti-inflammatory leukotriene C4 (LTC4) and the antioxidant glutathione (GSH). Our studies have focused on the role of MRP1 in regulating hematopoietic stem cell …

Breast Health And Access To Care In The Kentucky Women's Health Registry, Sarah Yeiser

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

Breast cancer is the second leading cause of death (14%) among all cancers in women in Kentucky.1 In 2010 the United States incident rates of breast cancer in white women were 122.6 per 100,000, and 118 per 100,000 in black women.2 Although breast cancer is diagnosed more in white women, black women are more likely to die from breast cancer and usually have more advanced stages of breast cancer upon diagnosis.2 In Kentucky from 2003-2007 the age-adjusted breast cancer mortality rate was 23.6 per 100,00 in white women and 32.8 per 100,000 black women. Black women die from breast cancer …

The Effect Of Television Watching On Condom Use Among 9th-12th Graders, Rashidat Mohammed

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

Abstract: At least one out of every three youth will acquire a Sexually Transmitted Infection (STI) by the time they reach 25 years old. Although this may be caused by a variety of factors, sexually-charged media are believed to play a significant role. In television, there are more sexually inaccurate messages than there are portrayals of sexually responsible behaviors. These messages are not only unrealistic, but they could potentially have negative effects on adolescent sexual behavior. Among these negative effects is failure to use condoms. When used correctly, male condoms are about 98% effective. Recommendations are presented to help address …

Improvement Of Tobacco-Free Policy Enforcement At The University Of Kentucky, Muchen Bai

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

Smoking has been known as the leading preventable cause of death and premature disease in the United States (DHHS, 2014). Every year, cigarette smoking causes more than 480,000, approximately, one in five deaths (DHHS, 2014). According to the Centers for Disease Control and Prevention (CDC), "smoking causes more deaths each year than all of the listed combined: Human immunodeficiency virus (HIV), Illegal drug use, Alcohol use, Motor vehicle injuries, and Firearm-related incidents" (CDC, 2014). Since 1964, 31 Surgeon General's Reports have revealed the causal relationship between health outcomes and tobacco smoke exposure (DHHS, 2014). The report, The Health Consequences of …

Association Between Co-Sleeping And Breastfeeding: Does Prenatal Care Make A Difference?, Brynne Kathleen Adams

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

Prenatal care is important to ensure a healthy pregnancy for both a woman and her baby. According to the Mayo Clinic, prenatal care should start as soon as there is a positive pregnancy test and should continue throughout the pregnancy.1 The more prenatal care visits a woman attends, the more opportunities to detect potential problems and offer health education materials to help ensure a healthy pregnancy. Prenatal care visits are also used to discuss what may happen after the woman delivers particularly early infant care and breastfeeding. Mothers who do not receive adequate prenatal care are three times more likely …

The Relationship Between Perceived High Levels Of Stress And Non-Condom Usage Among College Students At The University Of Kentucky, Samantha Bearman

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

Introduction: Due to the paucity of research that specifically examines the non-use of condoms, during sexual encounters, as a maladaptive coping strategy for stress among college students; the purpose of my study, is to determine if there is an association between perceived high levels of stress and the decreased likelihood of condom use during sex among students at the University of Kentucky. Method: The cross-sectional descriptive study investigated health behaviors and attitudes towards health behaviors in a sample of 7,000 University of Kentucky students enrolled in courses for fall 2013. Participants were randomly selected to partake in an anonymous online …

Impact Of Routine Immunization Coverage In Controlling Measles And Progressing Toward The Introduction Of Rubella Containing Vaccine: A Comparison Study Between Rwanda And Uganda, Carmen Kupangi Dibaya

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

Despite the existence of safe and effective vaccines, measles and rubella present a major public health problem in many developing countries, disproportionally affecting low-income populations.1-3 Indeed, measles and rubella remain two of the leading causes of death and congenital defects in children worldwide.4-6 In 2008, an estimated 10 million new cases and 164,000 deaths were reported from measles alone.3 During the same time period, the United Nations International Children's Emergency Fund (UNICEF) reported an estimated 110,000 cases of Congenital Rubella Syndrome (CRS) in developing countries, with the continent of Africa shouldering 38% of the disease burden.7 Measles is a highly …

An Evaluation Of Three Positive Parenting Practices And Their Combined Impact On Developmental, Social, Or Behavioral Delays In Children Ages 1-5 In The United States, Sarah Cprek

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

Objectives: (1) Determine whether three individual positive parenting practices (PPP) – reading to children, engaging in storytelling or singing, and eating meals together as a family – decrease the risk of developmental, behavioral, or social delays among children between the ages of 1-5 years in the United States. (2) Determine if a combination of these parenting practices has an additive effect on the outcome. Methods: Multiple logistic regression and chi-square analyses were used to analyze data from the National Survey of Children’s Health 2011/2012 in regards to the relationship between each of the three individual PPP as well as a …

Distribution Of Wildlife Rabies In Central Appalachia And Analysis Of Factors Influencing Human Exposure, Sara J. Reilly

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

Abstract Background: The rabies virus is a Lyssavirus of the family Rhabdoviridae which affects all mammals and causes progressive encephalomyelitis that is fatal in nearly one hundred percent of untreated cases. In the United States, wildlife act as the primary reservoir for rabies and prevention, surveillance, and control costs remain high. The purpose of this study is to understand the current distribution of wildlife rabies in Central Appalachia, as well as identify any demographic or geographic factors which may affect the risk of human exposure at the county level. Methods: A spatial statistical analysis using StatScan was performed to identify …

Narrative And Qualitative Analyses Of Workers' Compensation-Covered Injuries In Short-Haul Vs. Long-Haul Trucking Industries, Mark D. Chandler

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

ABSTRACT

Problem: Trucking transportation remains one of the most dangerous industries in the US. The aims of the current study were to (1) identify and characterize differences in injury types between workers in short-haul and long-haul trucking; (2) analyze and code narrative text to identify and characterize the on-the-job activities associated with injuries within each trucking industry group; and (3) identify areas for targeted improvement of safety interventions. Method: Quantitative and narrative analyses of 2012 Kentucky short-haul and long-haul truck transportation workers’ compensation first reports of injury and narrative text data were performed. Chi-square tests assessed differences in demographics, injuries, …

Examination Of The Prevalence And Mediating Factors Of Diabetes Diagnoses In Kentucky Women With A History Of Gestational Diabetes, Courtney Danielle Ryan

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

Diabetes mellitus (DM) is an overwhelming health issue in the United States affecting 25.8 million people, which is equivalent to 8.3% of the population.1 It is the seventh leading cause of death and a major cause of serious complications such as heart disease, stroke, kidney failure, nontraumatic lower limb amputations, and new causes of blindness among adults in the U.S.1 Paralleling the obesity epidemic, the rates of DM incidence and prevalence continue to rise each year.2 One particularly troubling public health issue related to DM is that over a quarter of the people who have this disease are unaware, even …

Connecting The Supply And Need For Buprenorphine Treatment In Kentucky Counties, Ellen Lavonne Parker

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

Abstract Background: Prescription opioid drug overdose mortality rates have surpassed those of motor vehicle accidents in Kentucky. While opioid overdose plagues the state, buprenorphine is an FDA approved medication that has proven effective in treating opioid dependence. Objectives: This study examined the supply of licensed buprenorphine providers and community treatment centers in each county of Kentucky along with the need for treating opioid use disorder in each county. Methods: Licensed buprenorphine physicians and community treatment centers prescribing buprenorphine were identified through the Substance Abuse and Mental Health Services Administration online treatment locator. The need for treatment was measured by calculating …

Study On Private Health Insurance Coverage For Adults Under 65: 34 States From 2003 To 2010, Weisheng Gu

MPA/MPP/MPFM Capstone Projects

Objectives: The analysis in this paper is designed to find out what factors contributed to the change of uninsured rate of people aged between 18 and 65 from 2003 to 2010.

Method: A fixed-effect analysis with panel data is conducted. The analysis unit is state. The main independent variable is the private health insurance cost per enrollee per year. The private insurance cost data covered 34 states sampled in Medical Expenditure Panel Survey from 2003 to 2010.

Key finding: The private insurance cost per enrolled adult below 65, private insurance cost per enrolled adult below 65 as a proportion of …