Medicine and Health Sciences Commons^™

Rural Speech-Language Pathologists' Perceptions And Knowledge Of Emergent Literacy Instructional Practices: A Mixed Methods Study, Kellie C. Ellis

Theses and Dissertations--Rehabilitation Sciences

The acquisition of emergent literacy skills has become a prominent focus of early childhood education programs in recent years as research has demonstrated the significance of emergent literacy ability in the process of learning to read. The effectiveness of use of varied instructional techniques targeting the emergent literacy domains of phonological awareness, written language awareness, emergent writing, and oral language is well described in the literature. Consequently, educational service providers like speech-language pathologists are being called upon to assume roles in emergent literacy service provision. However, research has not fully explored the perceptions and knowledge speech-language pathologists possess of emergent …

Use Of A Video Game Based Balance Training Intervention On The Balance And Function Of Children With Developmental Disabilities, Gina C. Siconolfi-Morris

Theses and Dissertations--Rehabilitation Sciences

Many children with developmental disabilities (DD) have physical impairments and limitations in their participation. Rehabilitation research often focuses on either physical impairments or participation restrictions, when both need to be investigated. The purposes of these two studies were to evaluate an at home therapist directed video game balance training intervention on balance, gait velocity (GV), hip strength and activities of children with DD. The pilot study was a single-subject non-concurrent multiple baseline design. Balance measures included: weight bearing symmetry; center of pressure area and velocity; time to boundary mean minima and standard deviation; and timed up and go. The participant’s …

The Development Of The Self-Efficacy Of Balance Scale (Sebs): Investigation Of Psychometric Properties In Female Basketball Players, Carrie Silkman Baker

Theses and Dissertations--Rehabilitation Sciences

Lower extremity injuries are the most common sports related injury. Many steps have been taken to attempt to identify individuals who might be at a higher risk for sustaining a lower extremity injury. Resource and time intensive screening techniques have been used previously to attempt to identify such individuals. However these techniques have focused heavily on postural control and landing mechanics in athletes, no psychological measure has been used to identify individuals who might be at a higher risk of lower extremity injury.

Self-efficacy of balance can be defined as how capable an individual feels he or she can balance …

The Use Of Explicit, Non-Evocative Print Referencing With Preschool Children At-Risk: Implications For Increasing Print Concept Knowledge, Susan Thomas Frank

Theses and Dissertations--Rehabilitation Sciences

The purpose of this research study was to investigate the learning of print concepts (PCs) by preschool children at risk for literacy problems using an experimental treatment: explicit, non-evocative print referencing. Children from low socio-economic status (SES) families have been determined to be at-risk for literacy learning problems including a reduced knowledge of print concepts.

The study incorporated a multiple group (experimental and control) time series design with persistent insertion of treatment to those subjects who were assigned to the experimental condition. Participants included 25 children at-risk, ages 4:0- 4:11 (years: months) who qualified for pre-school services and for subsidized …

Physical Activity, Sleep Patterns, And Health Outcomes In University Law Enforcement Officers, Nicole C. Koebke

Theses and Dissertations--Kinesiology and Health Promotion

Research indicates that law enforcement officers (LEOs) have a higher prevalence of developing coronary artery disease (CAD) compared to the general population. Sleep deprivation and physical inactivity have been found to be related to many risk factors for CAD. This cross-sectional study examined the health status and the relationship between sleep and physical activity outcomes versus CAD risk factors among 27 University LEOs. The subjects’ health behaviors, and CAD and metabolic syndrome risk factors were described using basic statistics. Accelerometer derived sleep and physical activity outcomes were correlated to measures of health to identify potential relationships. 33% of LEOs were …

Factors Relating To Hpv Behaviors Of Female College Students, Nicole Rachael Peritore

Theses and Dissertations--Kinesiology and Health Promotion

This study examined the knowledge, sources of information, reasons for and against Gardasil® uptake, and possible relationships between unhealthy behaviors and vaccination for undergraduate college females at a public university. Utilizing an online survey, 2400 random students were emailed as well as recruited through online classes. The final sample size was 516 females. The study determined how many participants had been vaccinated and their rationale for or against vaccination. The majority of study participants were knowledgeable about HPV and Gardasil®. The primary sources of information about HPV and Gardasil® were doctors and television; however parents and friends were also common …

The Impact Of Maternal Smoking In Kentucky And Effect Of The Giving Infants And Families Tobacco-Free Starts Pilot Project On Smoking Cessation And Birth Outcomes, Joyce Madeline Robl

Theses and Dissertations--Kinesiology and Health Promotion

Smoking during pregnancy remains a significant public health issue despite knowledge about the adverse maternal and fetal health effects. This research had six purposes: identifying effective smoking cessation strategies for low income pregnant women; identifying characteristics of Kentucky women who smoke during pregnancy; estimating the role of smoking on birth outcomes in Kentucky; exploring the impact of tobacco reduction on birth outcomes; identifying the characteristics of women participating in the Giving Infants and Families Tobacco-free Starts (GIFTS) pilot program; and evaluating the impact of GIFTS on smoking status and birth outcomes.

Seven randomized controlled trials targeting low income women with …

Energy Drink Consumption (With And Without Alcohol) And Its Relationship To Risky Behavior, Risk Awareness, And Behavioral Intention In College Students, Julia K. Buchanan

Theses and Dissertations--Kinesiology and Health Promotion

The purpose of this study was to assess the relationships between energy drink consumption (with and without alcohol) and other risky behaviors; students’ overall awareness level of the risks for consuming energy drinks; and overall behavioral intention to consume energy drinks among college students at the University of Kentucky. A total of 277 students enrolled during the Spring 2012 semester responded to the online survey, 46.5% (n=129) of which were considered energy drink users. Students classified as energy drink users participated in other risky behaviors more often than non-users (p=0.001). In addition, energy drink users exhibited a higher …

Relationships Of Access And Affordability To Household Food Security Status Among Rural, Low Income Caregivers, Jodi Elaine Marani

Theses and Dissertations--Kinesiology and Health Promotion

Household food security status in rural areas is a significant issue facing caregivers as positive health outcomes depend on appropriate access to healthy foods necessary to lead an active life. Access and affordability of healthy foods are two mediating factors of household food security that may be improved to ultimately increase rates of food security and overall health status among rural, low income populations.

The purpose of the study was to examine the factors of access and affordability of nutritionally adequate food sources in one rural community in relation to food security status through the perspective of its caregivers. In …

Noninvasive Assessment And Modeling Of Diabetic Cardiovascular Autonomic Neuropathy, Siqi Wang

Theses and Dissertations--Biomedical Engineering

Noninvasive assessment of diabetic cardiovascular autonomic neuropathy (AN): Cardiac and vascular dysfunctions resulting from AN are complications of diabetes, often undiagnosed. Our objectives were to: 1) determine sympathetic and parasympathetic components of compromised blood pressure regulation in patients with polyneuropathy, and 2) rank noninvasive indexes for their sensitivity in diagnosing AN. Continuous 12-lead electrocardiography (ECG), blood pressure (BP), respiration, regional blood flow and bio-impedance were recorded from 12 able-bodied subjects (AB), 7 diabetics without (D0), 7 with possible (D1) and 8 with definite polyneuropathy (D2), during 10 minutes supine control, 30 minutes 70-degree head-up tilt and 5 minutes supine recovery. …

Role Of The Immune System And Bioactive Lipids In Trafficking Bone Marrow-Derived Stem Cells In Patients With Ischemic Heart Disease, Ahmed Abdel-Latif

Theses and Dissertations--Microbiology, Immunology, and Molecular Genetics

Acute myocardial infarction (AMI) triggers the mobilization of stem/progenitor cells from bone marrow (BMSPCs) into peripheral blood (PB). The underlying mechanisms orchestrating this mobilization and subsequent homing of BMSPCs to the myocardium are poorly understood. While the role of traditional chemokines in the mobilization and homing of hematopoietic stem cell (HSCs) to BM niches is undisputed, their role in directing BMSPCs to the highly proteolytic environment of the ischemic myocardium is debatable and other redundant mechanism may exist. Based on our observation that bioactive lipids, such as sphingosine-1 phosphate (S1P) and ceramide-1 phosphate (C1P), play an important role in regulating …

Disruptions In The Regulation Of Extracellular Glutamate In The Rat Central Nervous System After Diffuse Brain Injury, Jason Michael Hinzman

Theses and Dissertations--Neuroscience

Glutamate, the predominant excitatory neurotransmitter in the central nervous system, is involved in almost all aspects of neurological function including cognition, motor function, memory, learning, decision making, and neuronal plasticity. For normal neurological function, glutamate signaling must be properly regulated. Disrupted glutamate regulation plays a pivotal role in the acute pathophysiology of traumatic brain injury (TBI), disrupting neuronal signaling, initiating secondary injury cascades, and producing excitotoxicity. Increases in extracellular glutamate have been correlated with unfavorable outcomes in TBI survivors, emphasizing the importance of glutamate regulation.

The aim of this thesis was to examine disruptions in the regulation of extracellular glutamate …

Regulation Of Hepatic Gene Expression During Liver Development And Disease, Hui Ren

Theses and Dissertations--Microbiology, Immunology, and Molecular Genetics

My first project was to investigate the role of Hepatocyte Nuclear Factor 1 (HNF1) and Nuclear Factor I (NFI) on alpha-fetoprotein (AFP) promoter activity during liver development. AFP is highly expressed in the fetal liver, silenced at birth, and remains at very low levels in the adult liver. A GA substitution located at -119 of the human AFP promoter is associated with hereditary persistence of AFP (HPAFP) expression in the adult liver (Hum Molec Genet, 1993, 2:379). The -120 region harbors overlapping binding sites for HNF1 and NFI. While it has been shown that the GA substitution increases HNF1 binding, …

Blast-Induced Brain Injury: Influence Of Shockwave Components, Dexter V. Reneer

Theses and Dissertations--Neuroscience

Blast-induced traumatic brain injury (bTBI) has been described as the defining injury of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF). Previously, most blast injury research has focused on the effects of blast on internal, gas filled organs due to their increased susceptibility. However, due to a change in enemy tactics combined with better armor and front-line medical care, bTBI has become one of the most common injuries due to blast. Though there has been a significant amount of research characterizing the brain injury produced by blast, a sound understanding of the contribution of each component of the shockwave to the …

Signaling Mechanisms Involved In The Generation Of Human Peripheral Itregs, Mary Catherine Reneer

Theses and Dissertations--Microbiology, Immunology, and Molecular Genetics

Maintaining balance in the human immune system is critical for the body’s ability to discriminate between foreign and self-antigens. This balance is achieved, in part, by a subpopulation of T cells known as induced regulatory T cells (iTregs). Dysregulation of this population may contribute to the onset and progression of cancer, chronic inflammation and autoimmune diseases. Therefore, manipulation of iTreg development holds promising therapeutic potential; however, studying this vital population has proven difficult due to low numbers, heterogeneous cell populations, substantial phenotypic differences between mouse and human cells, and the high plasticity seen in iTregs. These current limitations have prevented …

Crosstalk Between Gastrointestinal Epithelial Cells And Resident Microbiota Promotes Immune Homeostasis, Eric William Rogier

Theses and Dissertations--Microbiology, Immunology, and Molecular Genetics

The gastrointestinal tract houses one of the most dense and diverse communities of bacteria on the planet. The mutualistic relationship between the host and commensal microbe permits the microbe an ideal environment to grow and provides the host with increased caloric intake, maturation of the adaptive immune system, and resistance against invading pathogens. To maintain a system in which both parties benefit, the epithelium has evolved numerous strategies to ensure epithelial cells respond to microbes appropriately and that potentially hazardous commensals remain distanced from the soma proper. Breakdown of these propitiating mechanisms elicits unchecked inflammation and can lead to pathology …

Prion Characterization Using Cell Based Approaches, Vadim Khaychuk

Theses and Dissertations--Microbiology, Immunology, and Molecular Genetics

Prions are the causative agents of a group of lethal, neurodegenerative conditions that include sheep scrapie, bovine spongiform encephalopathy (BSE), and human Creutzfeldt-Jakob disease (CJD). Prions are derived from the conversion of a normal, primarily alpha-helical, cellular prion protein (PrP^C), to an infectious, beta sheet-rich conformer (PrP^Sc). Many unresolved issues surround the process of PrP conversion, and we know very little about cellular responses to these unique pathogens. Our lack of knowledge relates, in part, to the difficulty of infecting cells in vitro with prions. While expression of PrP^C is an absolute requirement for prion …

A Diet Enriched In Stearic Acid Protects Against The Progression Of Type 2 Diabetes In Leptin Receptor Deficient Mice (Db/Db), Valerie Lynn Reeves

Theses and Dissertations--Physiology

Dietary saturated fat intake contributes to diabetes and cardiovascular disease, as shown in numerous animal and human studies. However, the hypothesis that stearic acid, a saturated fat, has beneficial effects on these conditions has not been adequately tested. Leptin receptor deficient mice (db/db) and wild-type mice were fed either chow or a high fat diet enriched in either stearic acid or oleic acid for ten weeks. The progression of diabetes was evaluated with blood glucose, insulin, and metabolic parameter measurements. At the conclusion of the study, pancreatic islet organization was examined, and blood, liver and feces were assayed for fatty …

C-Abl And Arg Drive Cancer Chemoresistance Via Activation Of Multiple Signaling Pathways, Jonathan Thomas Sims

Theses and Dissertations--Pharmacology and Nutritional Sciences

Despite 35 years of clinical trials, there has been little improvement in one-year survival rates with any chemotherapeutic regimen for the treatment of metastatic melanoma due to resistance to all known agents. Regardless of advances in detection and prevention, diagnosis of metastatic disease remains a death sentence. Resistance mechanisms, including aberrant kinase signaling and drug transport pumps, indicate a need for identification of other therapeutic targets that impinge upon multiple signaling pathways. The Abl family of non-receptor tyrosine kinases (c-Abl, Arg) has been indicted as a causative force in leukemia for more than three decades; however, their role in solid …

Inflammatory Interactions And Secretion In Cardiac Remodeling, Fanmuyi Yang

Theses and Dissertations--Physiology

Heart failure contributes to nearly 60,000 deaths per year in the USA and is often caused by hypertension and preceded by the development of left ventricular hypertrophy (LVH). LVH is usually accompanied by intensive interstitial and perivascular fibrosis which may contribute to arrhythmogenic sudden cardiac death. Emerging evidence indicates that LV dysfunction in patients and animal models of cardiac hypertrophy is closely associated with perivascular inflammation.

To investigate the role of perivascular inflammation in coronary artery remodeling and cardiac fibrosis during hypertrophic ventricular remodeling, we used a well-established mouse model of pressure-overload-induced LVH: transverse aortic constriction (TAC). Early perivascular inflammation …

Evaluating Retention In Medical Care And Its Impact On The Health Outcomes Of Individuals Living With Human Inmmunodeficiency Virus, Timothy N. Crawford

Theses and Dissertations--Epidemiology and Biostatistics

In the last few years, engagement in medical care among individuals living with HIV has become a major priority among HIV medical providers and public health researchers. Engagement in medical care is an important concept as it involves the process of linking newly diagnosed individuals into medical care and retaining those individuals in care throughout the course of their infection. Although there have been major advances in the management of HIV, like the advent of Highly Active Antiretroviral Therapy, morbidity and mortality due to HIV cannot be fully reduced if the individual does not optimally retain in care. Retention in …

The Relationship Of Social Stress, Economic Hardship, And Psychological Distress To Addiction Severity Among Kentucky Substance Abuse Treatment Participants, Elizabeth A. Wahler

Theses and Dissertations--Social Work

Stress is associated with poor mental health, specifically anxiety and depression, and stress and mental health problems are predictors of substance dependence and relapse. Social characteristics, such as racial/ethnic minority status, female gender, and low socioeconomic status, are often associated with increased psychological distress and substance use disorders. Pearlin’s social stress theory postulates that this association is due to increased exposure to stress and subsequent experiences of distress related to social disadvantage and decreased access to resources for coping with stress. This project uses a social stress theoretical perspective to examine predictors of substance use after treatment entry and follow-up …

A Comparison Of Group Versus Individual Therapy On The Output Of Appropriate Utterances In A Six-Year-Old Girl With Autism: A Case Study, Mckinzie Craig Sheridan

Theses and Dissertations--Rehabilitation Sciences

Children with autism spectrum disorders typically experience language deficits in multiple areas, including form, content, and use. These children often receive speech therapy with individual sessions (one child and clinician), group sessions (several children), or a combination of both. Although research has deemed individual therapy successful, there is still debate regarding the success of group therapy, and there is virtually no literature examining a comparison between individual and group therapy. The current case-study investigated the relative effectiveness of individual versus group therapy for one six-year-old female with moderate autism spectrum disorder. The child underwent ten alternating therapy sessions of similar …

Effects Of Proximal Stability Training On Sport Performance And Proximal Stability Measures, Thomas Gerard Palmer

Theses and Dissertations--Rehabilitation Sciences

Proximal stability, or the ability to stabilize and actively control the spine, pelvis and trunk, has been reported to influence sport performance. Traditional training practices for the proximal segments have had little success improving sport performance. The purpose of this dissertation was to investigate the effects a sport specific proximal stability training program can have on throwing velocity and measures of muscular endurance and power which target the proximal segments of the pelvis, spine and trunk.

A stratified randomized clinical trial was implemented with a pre- to post-intervention design. Forty-six healthy, Division III collegiate female softball (n=17) and male baseball …

Environmental Influences On Occupational Therapy Practice, Camille L. Skubik-Peplaski

Theses and Dissertations--Rehabilitation Sciences

Rehabilitation hospitals serve to foster a client’s independence in preparation to return home after an injury or insult. Having space in rehabilitation environments that is home-like and supportive for each client can facilitate participation in occupations and assist in learning and practicing the skills needed to transition to home. Yet, typically occupational therapists provide interventions to clients in therapy gyms with exercise and impairment based equipment. Currently the stroke population is changing and identifying the optimal rehabilitation environment is imperative to guide occupational therapy practice. This dissertation contains three studies relating to the rehabilitation environment and occupational therapy interventions. The …

Reconstruction Of Nigrostriatal Pathway In An Animal Model Of Parkinson's Disease, Chen Zhang

Theses and Dissertations--Physiology

Parkinson's disease is characterized by progressive degeneration of substantia nigra (SN) and subsequently loss of the nigrostriatal circuit. Many strategies have attempted to reconstruct this circuit but failed to satisfy clinical trials. The inhibitory environment of the adult CNS and the long distance between the SN and the striatum make true reconstruction difficult. To reconstruct this circuit, we used a transplant-pathway targeting model. Several putative pathway targeting molecules were examined for their ability to direct the growth of axons from a dopaminergic transplant. For a proof-of-principle study, adenoviral and lentiviral encoded glial cell line-derived neurotrophic factor (GDNF), GDNF-receptor alpha1 (GFRa1 …

Symptom Assessment And Management In Patients With Heart Failure, Kyoung Suk Lee

Theses and Dissertations--Nursing

Patients with heart failure (HF) must monitor and recognize escalating symptoms to manage worsening HF in a timely manner. However, routine symptom monitoring is not commonly performed by this population.

Providing a symptom diary along with an education and counseling session may help HF patients promote symptom monitoring and interpretation. The accumulated information about changes in daily symptoms will allow patients to easily compare current symptom status to the past without depending on memory and can rapidly capture worsening HF. To date, few studies have tested the effect of a daily symptom diary.

The purpose of this dissertation was to …

Medically Ill Smokers And Planning To Quit, Audrey Darville

Theses and Dissertations--Nursing

Cigarette smoking is the leading cause of preventable disease and is the cause of nearly 1 in 5 deaths in the United States. The prevalence of smoking has had a leveling off effect after many years of significant decline. Certain subgroups of the population, such as those with low income and certain illnesses, continue to smoke at disproportionately high rates. Reasons for these disparities in smoking rates are complex. Developing a better understanding of the issues related to persistent smoking particularly for those with medical illness and limited access to cessation resources can help focus interventions to help these high …

Chronic Opioid Use In Fibromyalgia Syndrome: Characteristics And Outcomes, Jacob T. Painter

Theses and Dissertations--Pharmacy

Fibromyalgia syndrome (FMS) is a chronic pain condition with significant societal and personal burdens of illness. Chronic opioid therapy in the treatment of chronic nonmalignant pain has increased drastically over the past decade. This is a worrisome trend in general, but specifically, given the pathophysiologic characteristics seen in fibromyalgia syndrome patients, the use of this class of medication deserves special scrutiny. Although the theoretical case against this therapy choice is strong, little empirical evidence exists. In order to supplement this literature, retrospective analysis methods are utilized to examine the association of state-, provider-, and patient level characteristics with the prevalence …

Discovery Of Gz-793a, A Novel Vmat2 Inhibitor And Potential Pharmacotherapy For Methamphetamine Abuse, David B. Horton

Theses and Dissertations--Pharmacy

Methamphetamine abuse is a serious public health concern affecting millions of people worldwide, and there are currently no viable pharmacotherapies to treat methamphetamine abuse. Methamphetamine increases extracellular dopamine (DA) concentrations through an interaction with the DA transporter (DAT) and the vesicular monoamine transporter-2 (VMAT2), leading to reward and abuse. While numerous studies have focused on DAT as a target for the discovery of pharmacotherapies to treat psychostimulant abuse, these efforts have been met with limited success. Taking into account the fact that methamphetamine interacts with VMAT2 to increase DA extracellular concentrations; the focus of the current work was to develop …