Medicine and Health Sciences Commons^™

Pharmacy Law Brief: Contemporary Legal Issues For Leadership In Non-Profits - Iii, Joseph L. Fink Iii

Pharmacy Practice and Science Faculty Publications

No abstract provided.

United States: Mental Health Issues In An Adolescent Medicine Clinic Patient Population, Abdel Salous, Linah Al-Alem, Hatim A. Omar

Pharmacology and Nutritional Sciences Faculty Publications

The correlation between exposure to forms of violence and development of mental disorders in victims is well established. The purpose of this chapter was to identify mental health problems in an adolescent medicine clinic population in Lexington, Kentucky and to investigate potential correlation of mental disorders with psychosocial factors. Data were gathered from the charts of 169 adolescent clinic patients (age 10-22) seen in the clinic for mental health care and analyzed using Excel. Of the patient population, 68% were urban, whereas 32% were rural. In terms of gender, 40% of the patients were male and 60% were female, 80% …

Cattle-Related Injuries And Farm Management Practices On Kentucky Beef Cattle Farms, Steven R. Browning, Susan C. Westneat, Wayne T. Sanderson, Deborah B. Reed

Epidemiology and Environmental Health Faculty Publications

While working on farms with livestock increases the risk of injury among farm workers in comparison to other commodity farms, few studies have examined the role offarm management practices in association with the risk of cattle-related injury. We examined the farm management practices of Kentucky beef cattle farms in association with self-reported rates of cattle-related injuries among workers. We conducted a mail survey of a random sample of 2,500 members of the Kentucky Cattlemen's Association. Results from 1,149 farm operators who were currently raising beef cattle and provided complete survey response are reported. During the busy season, the principal operator …

Internet Addiction, Media Use, And Difficulties Associated With Sleeping In Adolescents, Stephanie Stockburger, Hatim A. Omar

Pediatrics Faculty Publications

The objective of this review article is to summarize the current literature regarding Internet addiction; media use, and sleep disruption in adolescents. Design: Systematic review of current literature. Methods: The data was obtained through literature review of articles published in the last 10 years. Conclusion: Internet addiction and media use have the power to have great influence over the sleep of children and adolescents and it is important to take advantage of the positive effects of media while minimizing the potentially negative, but severe, consequence of sleep disruption.

Cyberbullying: A Brief Review, Amy L. Burnett, John A. Yozwiak, Hatim A. Omar

Pediatrics Faculty Publications

The objective of this review is to summarize the prevalence of Internet use among the adolescent population and the growing threat of cyberbullying. This manuscript also addresses the difference between cyberbullying and traditional bullying and the negative psychological effects that result from cyberbullying. Important intervention and prevention strategies for parents and school officials are noted as well.

The Impact Of Discontinuing Coverage Of Second Generation Antihistamines In A Managed Care Organization, Matthew D. Harman

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

ABSTRACT Background: Second generation antihistamines (SGAs) are approved to treat seasonal and/or perennial allergic rhinitis (AR) and chronic idiopathic urticaria (CIU). It is estimated that 82% of Americans with AR use antihistamines, with the majority using SGAs due to their low side effect profile. As policy, over-the-counter (OTC) SGAs were not covered in this health plan population (cetirizine and loratadine products were available OTC prior to the study period, while fexofenadine products became available OTC during the study period). On January 1, 2012, the policy was extended to remove coverage of prescription-only SGAs (included desloratadine and levocetirizine products). Objectives: To …

Psychotropic Medication Utilization In Care Home Residents Age 65 Or Older Compared With The Equivalent General Population In Scotland, Tyler P. Stewart

MPA/MPP/MPFM Capstone Projects

Purpose: In Scotland, care homes provide assisted living and medical services. Psychotropic medications (antipsychotics, anxiolytics, and hypnotics) may be over utilized in these facilities. This study compared psychotropic medication utilization in elderly care home residents to the equivalent population of non-care home residents. It is hypothesized that patients in care homes utilize psychotropic medications more than non-care home residents.

Methods: Demographic and prescription information for all patients aged 65 years and older on January 1, 2011 who received at least one prescription for a psychotropic medication during 2011 was retrieved from the national Prescribing Information System (PIS). Patients were grouped …

Relationship Between Clandestine Methamphetamine Laboratory Seizures And Burns In Kentucky, David A. Wittmer

MPA/MPP/MPFM Capstone Projects

Methamphetamine is a highly addictive stimulant that is synthetically produced using equipment and chemicals available in the community. Its burden to society may be determined through a number of mechanisms, including the imposed strain on healthcare systems. The evolution of methamphetamine use and production methods has led to reports of increased methamphetamine related burn admissions among hospital burn units[1-3] . Current literature identifies an increase in injury severity, comorbid complications, and cost of care associated with methamphetamine related burn injuries[1-5]. The intent of this study is to identify burn injuries in Kentucky and assess whether a statistically significant association exists …

Student-Athletes And Drug Abuse Policies: A Study Of Drug Abuse Policies Of Athletics Departments In A Major Intercollegiate Athletics Conference, Jennifer Hale

MPA/MPP/MPFM Capstone Projects

No executive summary.

What Keeps Us Well? Professional Quality Of Life And Career Sustaining Behaviors Of Music Therapy Professionals, Shane C. Swezey

Theses and Dissertations--Music

Self-care can be seen as not only critical for individual professionals, but also for the growth of the helping professions and the quality of care which clients receive. The purpose of this study was to investigate use of career-sustaining behaviors and the levels of professional quality of life in music therapy professionals. This study investigated research questions regarding use of career sustaining behaviors and levels of professional quality of life, the relationship between these variables, the differences in the use of career sustaining behavior by demographics, and the use of music as a self-care strategy.

An online survey was sent …

The Influence Of Race And Socioeconomic Status On Routine Screening Practices Of Physician Assistants, Deshana Ann Collett

Theses and Dissertations--Educational Policy Studies and Evaluation

Health disparities in minorities and those of low socioeconomic status persist despite efforts to eliminate potential causes. Differences in the delivery of services can result in different healthcare outcomes and therefore, a health disparity. Some of this difference in care may attribute to discrimination resulting from clinical biases and stereotyping which may provide a possible source for the persistence of health disparities. Health disparities may occur because the delivery of services at some level is inadequate. Disparities resulting from the quality and quantity of care delivered by a practitioner result in differentiated delivery of healthcare, thus unequal health outcomes. The …

Untangling Neoliberalism’S Gordian Knot: Cancer Prevention And Control Services For Rural Appalachian Populations, George F. Bills

Theses and Dissertations--Sociology

In eastern Kentucky, as in much of central Appalachia, current local storylines narrate the frictions and contradictions involved in the structural transition from a post-WWII Fordist industrial economy and a Keynesian welfare state to a Post-Fordist service economy and Neoliberal hollow state, starving for energy to sustain consumer indulgence (Jessop, 1993; Harvey, 2003; 2005). Neoliberalism is the ideological force redefining the “societal infrastructure of language” that legitimates this transition, in part by redefining the key terms of democracy and citizenship, as well as valorizing the market, the individual, and technocratic innovation (Chouliaraki & Fairclough, 1999; Harvey, 2005). This project develops …

A Novel Selective Lipid Uptake Pathway Contributing To Ldl-Induced Macrophage Foam Cell Formation, Jason M. Meyer

Theses and Dissertations--Molecular and Cellular Biochemistry

Atherosclerosis is a disease characterized by cholesterol-rich plaques within the intima of medium and large arteries. Cholesterol deposition is thought to occur by infiltration of low-density lipoprotein (LDL) into lesions followed by uptake into macrophages, generating lipid-loaded “foam cells.” Foam cells can also be generated in vitro by treatment of macrophages with LDL or oxidized LDL (oxLDL). The purpose of the current investigation was to determine the contribution of selective cholesteryl ester (CE) uptake versus whole-particle uptake during LDL-induced foam cell formation in cultured macrophages. Murine bone marrow-derived macrophages (BMMs) exhibited significant cholesterol accumulation when treated with LDL as indicated …

Lamotrigine Augmentation Of Serotonin Reuptake Inhibitors In Severe And Long-Term Treatment-Resistant Obsessive-Compulsive Disorder, Manuel Arrojo-Romero, María Tajes Alonso, Jose De Leon

Psychiatry Faculty Publications

The treatment recommendations in obsessive-compulsive disorder (OCD) after lack of response to selective serotonin reuptake inhibitors (SSRIs) include augmentation with other drugs, particularly clomipramine, a more potent serotonin reuptake inhibitor (SRI), or antipsychotics. We present two cases of response to lamotrigine augmentation in treatment-refractory OCD; each received multiple SRI trials over a >10-year period. The first patient had eleven years of treatment with multiple combinations including clomipramine and SSRIs. She had a >50% decrease of Y-BOCS (from 29 to 14) by augmenting paroxetine (60 mg/day) with lamotrigine (100 mg/day). The second patient had 22 years of treatment with multiple combinations, …

Nurse Practitioner Knowledge Of Urine Drug Testing, Jessica L. Estes

DNP Projects

This DNP Capstone seeks to the review the literature surrounding provider knowledge of urine drug testing, evaluate the use of psychiatric mental health nurse practitioners as treating professionals, and to investigate the knowledge of current nurse practitioners related to urine drug testing.

The Effect Of Coaching On Nurse Manager Leadership Of Unit Based Performance Improvement: Exploratory Case Studies, Cynthia A. Baxter

DNP Projects

The nurse manager role has experienced an explosion of responsibilities and expectations over the last decade. As a result, competency and skill acquisition for the successful nurse manager has become the focus of many nurse managers, nurse executives, researchers and organizations. The three manuscripts contained in this final capstone report will explore the acquisition of nurse manager competency, propose coaching as a methodology for acceleration and improvement of nurse manager skill acquisition and describe the results of three case studies using coaching as an intervention to improve the performance improvement skill acquisition of nurse managers.

An Update On Vitamin D: The Role In Chronic Disease, Clinical Practice Implications, And The Current Status Of Nurse Practitioner Knowledge, Sara E. Robertson

DNP Projects

The discovery that a large portion of the United States population is vitamin D deficient, has led to hundreds of studies in the last decade which aim to discover the role of vitamin D in overall health and to determine what clinical consequences occur in a deficient state. The current clinical knowledge regarding vitamin D deficiency is reviewed, including the definition of vitamin D insufficiency and deficiency and its correlation to chronic disease states; the risk factors and epidemiology of vitamin D deficiency; and appropriate clinical screening and treatment of vitamin D deficiency. A research study completed in 2012 to …

Military Tobacco Dependence Treatment: Implications Of Treatment Type On Abstinence And Weight Management Ability, Bradley A. Briscoe

DNP Projects

Military readiness, employer productivity and individual health are all significantly impacted by high rates of tobacco use. Current research, to date, suggests that use of brief, individually tailored behavioral modification strategies through group therapy may be most effective in smoking cessation. The objective of this Practice Inquiry Project was to explore aspects of tobacco use the U.S. military population and examine potential relationships between type of treatment, smoking abstinence, and maintenance of body weight (e.g. avoid weight gain) among those seeking tobacco use cessation. The findings of this project can provide guidance on enhancing current tobacco cessation efforts to enable …

Evaluation Of Depression Screening Practices For College Women In A Primary Care University Health Clinic, Sarah E. Lester

DNP Projects

Mental disorders, including depression, are increasing in frequency and intensity in the college student population. College-aged women appear to be particularly vulnerable to depression. Primary care providers play an important role in addressing this issue, as they are the principal health care contacts for more than 50% of patients with mental illnesses. Guidelines from the 2009 United States Preventative Services Task Force recommend screening all adults (age 18+) for depression in primary care when depression care supports are in place. However, current screening rates for depression in the primary care setting from are estimated at only 1.6 to 3.3% (United …

Educational Materials And Brief Counseling Improve Diabetes Knowledge And Self-Efficacy, Tamara K. Wellman

DNP Projects

Purpose: The purpose of this study was to see if education and counseling of the Appalachian individual with diabetes and a family member/friend would improve knowledge of the disease and self-efficacy of the patient in regard to their diabetes care.

Setting: The setting was one of eight primary care offices of Our Lady of Bellefonte Hospital, Bon Secours, located in the Ashland, Kentucky.

Design: A pilot study of descriptive, comparative design was used.

Subjects: Data were collected from a convenience sample of patients with type 2 diabetes (n=15) that were established at the primary care office and their family members/friends …

Evaluating Discharge Readiness Of Patients At A Primary Stroke Center, Amanda Green

DNP Projects

The diagnosis of stroke is very prevalent in healthcare and it is estimated that someone in the United States suffers from a stroke every 40 seconds (Lloyd-Jones et al., 2009). In order to optimally prepare these patients for discharge and improve patient outcomes, it is important to understand the needs of the patient and caregiver and to meet these needs. In order to evaluate this, the focus of this project was to evaluate the discharge readiness of patients at a primary stroke center. “Discharge Needs of the Stroke Patient and Caregiver” focuses on a review of the literature in order …

Predicting The Risk Of Obstructive Sleep Apnea And Difficult Endotracheal Intubation In A Surgical Population In A Rural Community Hospital Setting, Craig S. Atkins

DNP Projects

Purpose:

The purpose of this paper is to provide a theoretical framework with practical application for facilitating patient flow through the operative process using the Lean philosophy to minimized delays and cancellations.

Theoretical orientation:

Efficient, quality patient care has always been the hallmark of Nurse Anesthetist practice. Lean healthcare introduces continuous quality improvement (CQI) processes used in Lean manufacturing to the healthcare system. The principal aspect of Lean healthcare is the concept of a value stream where work is standardized, work flow is streamlined and waste is eliminated, thus creating value.

Nature of Review:

In the surgical suite waits, delays …

Doxorubicin-Induced, Tnf-Α-Mediated Brain Oxidative Stress, Neurochemical Alterations, And Cognitive Decline: Insights Into Mechanisms Of Chemotherapy Induced Cognitive Impairment And Its Prevention, Jeriel T. Keeney

Theses and Dissertations--Chemistry

The works presented in this dissertation provide insights into the mechanisms of chemotherapy-induced cognitive impairment (CICI or “ChemoBrain”) and take steps toward outlining a preventive strategy. CICI is now widely recognized as a complication of cancer chemotherapy experienced by a large percentage of cancer survivors. Approximately fifty percent of existing FDA-approved anti-cancer drugs generate reactive oxygen species (ROS). Doxorubicin (Dox), a prototypical ROS-generating chemotherapeutic agent, produces the reactive superoxide radical anion (O₂^-•) in vivo. Dox treatment results in oxidation of plasma proteins, including ApoA-I, leading to TNF-α-mediated oxidative stress in plasma and brain. TNF-α elevation in brain …

The Role Of Bridging Therapy In Hepatocellular Carcinoma, Roberto Galuppo, Angie Mccall, Roberto Gedaly

Surgery Faculty Publications

Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver accounting for 7% of all cancers worldwide. Most cases of HCC develop within an established background of chronic liver disease. For that reason, liver resection is only possible in selected patients. Liver transplantation has become the treatment of choice in patients with HCC, end-stage liver disease, and significant portal hypertension. Shortage of organ donors has resulted in overall increase of waiting list time with increased risk of dropout due to tumor progression. Neoadjuvant therapies have emerged as an alternative to control tumor growth in patients while waiting. The …

Evaluation Of Echo Ps Positioning System In A Porcine Model Of Simulated Laparoscopic Ventral Hernia Repair, Erin M. Hanna, Guy R. Voeller, J. Scott Roth, Jeffrey R. Scott, Darcy H. Gagne, David A. Iannitti

Surgery Faculty Publications

Purpose. Operative efficiency improvements for laparoscopic ventral hernia repair (LVHR) have focused on reducing operative time while maintaining overall repair efficacy. Our objective was to evaluate procedure time and positioning accuracy of an inflatable mesh positioning device (Echo PS Positioning System), as compared to a standard transfascial suture technique, using a porcine model of simulated LVHR. Methods. The study population consisted of seventeen general surgeons (n = 17) that performed simulated LVHR on seventeen (n = 17) female Yorkshire pigs using two implantation techniques: (1) Ventralight ST Mesh + Echo PS Positioning System (Echo PS) and …

A 22-Year-Old Female With Invasive Epithelioid Angiomyolipoma And Tumor Thrombus Into The Inferior Vena Cava: Case Report And Literature Review, Campbell Grant, John M. Lacy, Stephen E Strup

Surgery Faculty Publications

A 22-year-old female presented with back pain and was discovered to have a right-sided abdominal mass. Computed tomography (CT) scan revealed a 9 cm enhancing right upper pole renal mass with suspicion for tumor thrombus into the right renal vein and possibly the inferior vena cava (IVC). Magnetic resonance imaging (MRI) confirmed tumor thrombus into the inferior vena cava approximately 3 cm below the hepatic venous confluence. Open right radical nephrectomy with inferior vena cava thrombectomy was performed with removal of right kidney and tumor thrombus en bloc. Pathology revealed malignant epithelioid angiomyolipoma (EAML or PEComa). Epithelioid angiomyolipoma is a …

Reinforcing, Subjective, And Cognitive Effects Of Methamphetamine During D-Amphetamine Maintenance, Erika Pike

Theses and Dissertations--Psychology

Translational research suggests that agonist replacement may be a viable treatment approach for managing methamphetamine dependence. This study sought to determine the effects of d-amphetamine maintenance on methamphetamine self-administration in stimulant using participants. A cognitive battery was used to determine the performance effects of methamphetamine alone and during d-amphetamine maintenance. During each maintenance condition, participants first sampled a dose of intranasal methamphetamine then had the opportunity to respond on a progressive ratio task to earn portions of the sampled dose. Subject-rated drug-effect and physiological measures were completed prior to and after sampling methamphetamine. Methamphetamine was self-administered as function …

Expression Of Borderline Personality Disorder Symptoms Across The Ovulatory Cycle: A Multilevel Investigation, Tory A. Eisenlohr-Moul

Theses and Dissertations--Psychology

Borderline Personality Disorder (BPD) is a disabling condition characterized by chronic emotion dysregulation and behavioral impulsivity. Prospective studies that test proposed mechanisms of within-person change in BPD hold the key to improving symptom predictability and control in this disorder. A small body of evidence suggests that fluctuations in estradiol such as those occurring naturally at ovulation during the monthly female reproductive cycle may increase symptoms in women with BPD (DeSoto et al., 2003). Furthermore, there is preliminary evidence that both self-esteem and feelings of social rejection are highest at ovulation, when estradiol peaks (Durante and Hill, 2009; Eisenlohr-Moul et al., …

The Mesocorticolimbic Dopamine Pathway Reconstituted In Vitro: Glutamate Receptors And Corticosteroid-Methamphetamine Neurotoxicity, Jennifer N. Berry

Theses and Dissertations--Psychology

Stress promotes the use of methamphetamine and other recreational substances and is often implicated in relapse to stimulant use. Thus, it is of critical importance to examine the consequences of the co-occurance of stress and methamphetamine use. Activity of the glutamatergic N-methyl D-aspartate (NMDA) receptor system appears to be involved in the neurotoxic effects of both chronic stress and methamphetamine exposure. The current studies investigated the hypothesis that chronic pre-exposure to the stress hormone corticosterone (CORT) results in an increase of NMDA receptor activity and that this will potentiate the neurotoxic effects of methamphetamine (METH). Co-cultures of the …

Development Of A Patient Specific Image Planning System For Radiation Therapy, Bishnu Bahadur Thapa

Theses and Dissertations--Physics and Astronomy

A patient specific image planning system (IPS) was developed that can be used to assist in kV imaging technique selection during localization for radiotherapy. The IPS algorithm performs a divergent ray-trace through a three dimensional computed tomography (CT) data set. Energy-specific attenuation through each voxel of the CT data set is calculated and imaging detector response is integrated into the algorithm to determine the absolute values of pixel intensity and image contrast. Phantom testing demonstrated that image contrast resulting from under exposure, over exposure as well as a contrast plateau can be predicted by use of a prospective image planning …