Medicine and Health Sciences Commons^™

Vegetarians And Vegans In Kentucky, Danita Martha Hines

University of Kentucky Master's Theses

Kentucky has a health crisis and most of the causes can be linked to diet, smoking and physical activity. Vegetarian and vegan diets have numerous benefits for many diet related health problems such as obesity, heart disease, Type 2 diabetes and certain cancers. There has been limited research on vegetarians and vegans in the United States and none in Kentucky. This study used an anonymous electronic survey to examine the different characteristics, behaviors, experiences and opinions of adult vegetarians and vegans in Kentucky. Results were compared to statistical data reported on the general population of Kentucky. Calculated body mass index …

Dietitians’ Use And Perceptions Of Nutrition Screening Tools For The Older Adult, Sarah Ross Small

University of Kentucky Master's Theses

Malnutrition is a significant issue affecting the health of many adults over the age of 65. Screening for malnutrition in this population can help identify those in need of a complete nutritional assessment. Many screening tools have been developed to aid healthcare team members in identifying those at risk for malnutrition. A population of dietitians with a focus in older adult nutrition was surveyed to determine dietitians’ perceptions and use of screening tools for the older adult. The results of the study showed many dietitians did not use validated screening tools at their place of work and were not confident …

The Relationship Between Obesity And Skin And Soft Tissue Infections, Juliana Swiney

MPA/MPP/MPFM Capstone Projects

The Problem:

It is well known that our country is experiencing an obesity epidemic: 33.9% of all adults are obese (BMI>30) and 67% of adults are either overweight or obese (BMI>25). Obesity is a risk factor for several serious disease states such as, diabetes, stroke, hypertension, heart disease and some types of cancer. It also has a less well defined relationship with skin and soft tissue infections.

Although it is known that excessive weight increases the opportunity for harmful skin conditions, this relationship has not been as well studied. Some of the mechanisms that predispose obese people to …

Radical Hysterectomy With Pelvic Lymphadenectomy: Indications, Technique, And Complications, Rachel A. Ware, John R. Van Nagell Jr.

Obstetrics and Gynecology Faculty Publications

Radical hysterectomy with pelvic lymphadenectomy remains the treatment of choice for women with Stages IA₂ and IB₁carcinoma of the cervix, and selected patients with Stage II endometrial cancer. Improvement in surgical techniqe, administration of prophylactic antibiotics, thromboemolic prophylaxis, and advances in critical care medicine have resulted in lower operative morbidity associated with this procedure. Major urinary tract complications such as ureteral injury or vesico-vaginal fistula are now extremely rare (< 1%). Five-year survival rates following this procedure vary according to a number of clinical and histologic variables, and may be as high as 90% in women without lymph node metastases.

Health Promotion And Health Education: Nursing Students’ Perspectives, Kathleen Ann Halcomb

University of Kentucky Doctoral Dissertations

The purpose of this study was to determine student nurses’ perceptions of (1) the role of the nurse in health promotion, and (2) how the concept of health promotion is presented in nursing curricula. Research questions for this study included the following: 1) Can nursing students explain the difference between health education and health promotion? 2) What have nursing students been exposed to within their curriculum regarding health promotion? 3) What health promoting behaviors are nursing faculty role modeling as perceived by nursing students? 4) What is the role of the nurse in implementing health promotion as perceived by nursing …

Drug Release And Pharmacokinetic Properties Of Liposomal Db-67, Yali Liang

University of Kentucky Master's Theses

Sterically stabilized liposomes with saturated lipid as the major lipid component (DSPC:m-PEGDSPE were applied in DB-67 delivery. The drug retention in vitro and pharmacokinetic properties in vivo were investigated. Liposomal DB-67 was cleared faster from the circulation in the larger liposomes (~180 nm) than in the smaller ones (~120 nm), even though DB-67 was retained longer in smaller size liposomes in vitro. Liposomal DB-67 clearance was increased when cholesterol was present in the liposomal composition (40 mole %). It can be attributable to the faster drug release from cholesterol containing liposomes as compared to liposomes without cholesterol. Cholesterol free …

The Cost Of Medication Errors In The Emergency Department: Implications For Clinical Pharmacy Practice, Benjamin Bowman

MPA/MPP/MPFM Capstone Projects

Introduction

The main purpose of this capstone project is to provide an objective analysis of the cost of a medication error in the emergency department. The secondary objective of this analysis is to estimate the cost avoidance impact of providing clinical pharmacy services in the emergency department (ED).

Literature review

Previous literature has described the scope of clinical pharmacy services in the ED and has, to some extent, presented economic outcomes analyses of the impact of these services (Cohen et al., 2009; Lada and Delgado, 2007). According to Cohen et al., the current literature is still lacking a formal pharmacoeconomic …

Community Needs Assessment Of Mayasandra Village, Karnataka, India, Alexander Hernandez Holl

MPA/MPP/MPFM Capstone Projects

No executive summary.

Inhibition Of Cholesterol Synthesis By Policosanol, Subhashis Banerjee

University of Kentucky Doctoral Dissertations

Cholesterol is an essential component of the cell, but excessive blood levels are a major risk factor for the development of atherosclerotic plaques that can lead to heart disease and stroke, the foremost cause of premature death in Western societies. Policosanol, a mixture of very long chain alcohols derived from sugarcane, has gained considerable attention among the public as safe and effective means to reduce blood cholesterol levels, a belief based on some early clinical studies. My research investigates one possible mechanism by which policosanol might decrease blood cholesterol levels: the inhibition of cholesterol synthesis in the liver. Previous studies …

Auditory Training At Home For Adult Hearing Aid Users, Anne D. Olson

University of Kentucky Doctoral Dissertations

Research has shown that re-learning to understand speech in noise can be a difficult task for adults with hearing aids (HA). If HA users want to improve their speech understanding ability, specific training may be needed. Auditory training is one type of intervention that may enhance listening abilities for adult HA users.

The purpose of this study was to examine the behavioral effects of an auditory training program called Listening and Communication Enhancement (LACE™) in the Digital Video Display (DVD) format in new and experienced HA users. No research to date has been conducted on the efficacy of this training …

Injury-Induced Hand Dominance Transfer, Kathleen E. Yancosek

University of Kentucky Doctoral Dissertations

Hand dominance is the preferential use of one hand over the other for motor tasks. 90% of people are right-hand dominant, and the majority of injuries (acute and cumulative trauma) occur to the dominant limb, creating a double-impact injury whereby a person is left in a functional state of single-handedness and must rely on the less-dexterous, non-dominant hand. When loss of dominant hand function is permanent, a forced shift of dominance is termed injury-induced hand dominance transfer (I-IHDT).

Military service members injured in combat operation may face I-IHDT following mutilating injuries (crush, avulsion, burn and blast wounds) that result in …

What Nurses Say: Communication Behaviors Associated With The Competent Nursing Handoff, Anne Claiborne Ray Streeter

University of Kentucky Doctoral Dissertations

Communication competence and medical communication competence served as the theoretical framework for this research that seeks to identify specific communication behaviors associated with what nurses say constitute a communicatively competent patient handoff at the nursing change of shift. Data collected from 286 nurses responding to an online modified Medical Communication Competence Scale posted at www.allnurses.com supported the hypotheses that information exchange (information giving, seeking and verifying) and socioemotional communication behaviors are rated more highly in the best patient handoffs than in the worst ones. Research questions found that the incoming nursing role rated behaviors associated with information verifying and socioemotional …

Health System Processes, Clinician Attitudes, And Referrals To Tobacco Treatment Programs, Karma Bryan Cassidy

University of Kentucky Doctoral Dissertations

Assisting smokers to quit and stay quit is the most important intervention clinicians can undertake to improve the length and quality of life of patients who use tobacco. The chronic, relapsing nature of tobacco dependence complicates tobacco treatment. Tobacco treatment counseling programs provide on-going support to help patients avoid relapse. Assistance with a referral increases the likelihood that patients will participate in counseling, but few clinicians regularly assist with referrals to tobacco treatment programs. This dissertation examined health system processes and clinician attitudes that influence the likelihood that clinicians will refer their patients for tobacco treatment counseling.

Three papers examined …

Cardiac Rhythm During Mechanical Ventilation And Weaning From Ventilation, Muna Hassan Hammash

University of Kentucky Doctoral Dissertations

The transition from mechanical ventilation (MV) to spontaneous ventilation during weaning is associated with hemodynamic alterations and autonomic nervous system (ANS) alterations (reflected by heart rate variability [HRV]). Although cardiac dysrhythmias are an important manifestation of hemodynamic alterations, development of dysrhythmias during MV and weaning and subsequent impact on length of MV has received little attention.

The purposes of this dissertation were to 1) evaluate the relationship of heart rate variability (HRV) during weaning to the development of cardiac dysrhythmias and 2) determine the relationship of cardiac dysrhythmias to length of MV.

A convenience sample of 35 patients (66.7% men; …

Modulation Of The Alpha-7 Nicotinic Acetylcholine Receptor Following Experimental Rat Brain Injury Improves Cellular And Behavioral Outcomes, Thomas Matt Woodcock

University of Kentucky Doctoral Dissertations

Traumatic brain injury (TBI) is a leading cause of death and long-term disability worldwide, and survivors are often left with cognitive deficits and significant problems with day to day tasks. To date, therapeutic pharmacological treatments of TBI remain elusive despite numerous clinical trials. An improved understanding of the molecular and cellular response to injury may help guide future treatment strategies. One promising marker for brain injury is the translocator protein (TSPO), which is normally expressed at a low level, but is highly expressed following brain damage and is associated with neuroinflammation. The isoquinoline carboxamide PK11195 binds selectively to the TSPO …

Acute Musculoskeletal Sports Injury And Topical Nsaid, Amit M. Deokar, Shawn J. Smith, Hatim A. Omar

Pediatrics Faculty Publications

The objective of this chapter is to summarize the current standards of pain management in minor sports related musculoskeletal injuries. We also address the topical form of non-steroidal anti-inflammatory drug as an effective pain management option in an out-patient setting. Design: Quantitive systematic review of randomized controlled trials. Methods: The data was obtained through literature review of articles published in the last 10 years. In addition, FDA information on non-steroidal anti-inflammatory medications was also reviewed. The patient population studied in the articles included children and adults. Conclusion: Current standards of managing pain resulting from sports injuries involve a number of …

Down Syndrome And Sexuality, Maria José Carvalho Sant'anna, Bruna Marques Bononi, André Chao Vasconcellos De Oliveira, Tadeu Silveira Renattini, Carla Franchi Pinto, Maria Lucia Passarelli, Veronica Coates, Hatim A. Omar

Pediatrics Faculty Publications

In recent years important gains and changes have been observed in the life of teenagers with Down syndrome (DS) with increased inclusion into society. This chapter will discuss adolescence and sexuality in teenagers with DS from a descriptive study of 50 patients with DS between the ages of 10 and 20 years. The mean age was 13.5 years, 50% females. 86% went to school with 62.2% in school for over six years. Of the patients that attended school, 60% went to special education school and only 10% read and wrote correctly. In evaluation of autonomy, 66% took shower, 78% performed …

Chronic Illness And Mental Health Issues, Marlene B. Huff, Kimberly K. Mcclanahan, Hatim A. Omar

Pediatrics Faculty Publications

By 2015, worldwide, 1.2 billion children aged 5-14 years will have some kind of significant chronic disease. Although scientific evidence indicates that children with chronic illness have more mental health issues than their healthy peers, many controversies and gaps in the literature exist. It is imperative that an understanding of the effects of chronic illness upon the mental health status of children and adolescent be undertaken. This article uses a biopsychosocial perspective to investigate the connection between chronic illness and mental health. The intent of the article is to suggest ways that medical and mental health professionals can provide services …

Educating Adolescents About Puberty: Are We Missing Something?, Hatim A. Omar

Pediatrics Faculty Publications

Adolescents undergo significant physical and cognitive changes during their pubertal development. These changes contribute to and impact their future development. Educating adolescents at an early age about their expected development decreases the possible anxiety associated with this period of life and also helps adolescents make better choices in regards to their sexuality. In order to assess the degree of education regarding pubertal development and sexuality, we conducted a survey of late adolescents (median age 19 years) and parents of adolescents. A total of 409 adolescents (237 females, 172 males) and 124 parents completed the survey. 14.4% of teens (36.6% of …

Mental Health Aspects Of An Adolescent Medicine Clinic Patient Population, Abdel Salous, Linah Al-Alem, Hatim A. Omar

Pediatrics 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, KY 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. 68% of the patient population was urban, while 32% was rural. In terms of gender, 40% of the patients were male and 60% were female. 80% …

Quality Of Life And Adolescents In Rural Kentucky, Hatim A. Omar, Søren Ventegodt, Joav Merrick

Pediatrics Faculty Publications

In many rural areas in Kentucky, adolescents lack the basic assets for a good quality of life, such as having caring adults, a safe place and useful activities after school. In this chapter we analyze data from middle and high school students referred to a comprehensive school based health promotion center (SBHPC). From August 2006 to February 2008, a total of 382 students (200 female, 182 male, aged 12-18 years) were referred to the SBHPC for help. Only two (0.5%) students had two parents living with them and 12 (3.1 %) had safe, organized after school activities. 19.9% of the …

The Vampire Adolescent, Megan White, Hatim A. Omar, Joav Merrick

Pediatrics Faculty Publications

No abstract provided.

Quality Of Life And Persons With Intellectual Disability: Can We Measure Qol In This Population?, Søren Ventegodt, Hatim A. Omar, Flemming Struve, Tove K. Nielsen, Isack Kandel, Joav Merrick

Pediatrics Faculty Publications

Quality of life (QOL) has been discussed by professionals working with persons with intellectual disability (ID) for some time, but since QOL is concerned with subjective well-being, satisfaction and happiness, how is it possible to measure, when the person in question is unable to communicate? Consciousness is believed to be an internal and personal thing, but we have done the simple experiment to ask observers to rate QOL of another person, also in sub dimensions like self-assessed physical and mental health, relationship with self, self-assessed sexual ability, self-assessed social ability, and we have found that people are able to assess …

Prepubertal Office Gynecology, Hatim A. Omar, Wendy Jackson, Amit M. Deokar

Pediatrics Faculty Publications

Clinical presentation and complaints of the vulvo-vaginal area are quite prevalent in the pediatric population and the primary care providers the first individuals called upon to evaluate the patients. One of the most difficult tasks for an individual that rarely performs the genitourinary examination is performing one on a pediatric patient. This chapter has been written to aid the primary care provider in successful examination, documentation and diagnosis.

Ovarian Tumors In Children And Adolescents, Linah Al-Alem, Amit M. Deokar, Rebecca Timme, Hatim A. Omar

Pediatrics Faculty Publications

Ovarian tumors are uncommon in the child and adolescent population, but given that cancer is a leading cause of death even in this age group it is important for the general practice physician to be aware of the signs and symptoms. These can include abdominal pain, increased abdominal girth, a palpable mass on pelvic or abdominal exam, nausea and vomiting, decreased appetite, weight loss, constipation, back pain, leg cramps, dyspareunia, urinary symptoms, abnormal uterine bleeding, and ascites, to name a few. The types of gynecological tumors seen in adults are also seen in children except in differing frequencies. The most …

Contraception, Donald E. Greydanus, Hatim A. Omar, Lyubov A. Matytsina, Artemis Tsitsika

Pediatrics Faculty Publications

Contraception is an important concept for sexually active adolescent females to understand who do not wish to become pregnant. This chapter reviews important, effective, and safe contraceptive methods that can be used by female youth. These methods include abstinence, oral contraception, contraceptive patch. mini-pills, emergency contraceptives, injectable contraception (DMPA), implants (lmplanon), intravaginal ring, vaginal barrier contraceptives, intrauterine devices, and natural family planning. Promotion of sexual responsibility should be the charge of health professionals caring for adolescents and young adults.

Breast Disorders In Children And Adolescents, Donald E. Greydanus, Hatim A. Omar, Lyubov A. Matytsina, Artemis Tsitsika

Pediatrics Faculty Publications

Concerns about problems of the breast are often noted in adolescents and their parents. This review discusses issues and disorders of the breast in children and adolescents, starting with basic principles of embryology and adolescent breast development. Concepts that are covered include congenital breast disorders, abnormal timing of breast development, breast asymmetry, underdeveloped breasts, breast atrophy, tuberous breasts, mammary hyperplasia, fibroadenoma, giant fibroadenoma, cystosarcoma phyllodes, intraductal breast papilloma, adenocarcinoma, mastitis, traumatic breast disorders, benign breast disease, fibrocystic change, mastalgia, gynocomastia, and galactorrhea. A number of figures are provided illustrating breast pathology. Clinicians caring for children and adolescents are encouraged to …

Menstrual Disorders In Adolescent Females, Donald E. Greydanus, Hatim A. Omar, Artemis Tsitsika, Dilip R. Patel

Pediatrics Faculty Publications

Onset of menstruation (i.e., menarche) is a determining event of the adolescent female signifying the progress of puberty, which in the majotity of cases is visibly initiated with thelarche (onset of breast development or breast buds). Menarche usually occurs during the earlier time of the second decade of life and ends with menopause, typically in the 5th decade of life. The adolescent can present with a wide variety of menstrual dilemmas and disorders which will be discussed in this chapter.

Foothills Academy: A Program Ranking And Comparative Analysis Of Residential Treatment Programs, William Aaron

MPA/MPP/MPFM Capstone Projects

The Foothills Academy is an all male adolescent residential treatment facility in Albany, Kentucky. As more states turn toward alternative treatment options to address the growing needs of youth suffering from mental and emotional disorders and substance abuse issues, demand for more efficient treatment programs is on the rise. To remain competitive and to administer the best treatment services for their clients, residential treatment programs must utilize industry best practices that allow efficient use of public funds. By identifying high performing programs, those programs may then be studied to identify factors key to individual program success.

My findings were consistently …

What Is The Impact Of Kentucky’S Pharmacy Recovery Network?, Benjamin Paul Clark

MPA/MPP/MPFM Capstone Projects

Problem Statement: This capstone will focus on Kentucky’s Pharmacy Recovery Network (PRN). In general, professional recovery networks are organizations that act as a liaison between professional state boards and the health professionals who are dealing with substance abuse and addictions that sometimes result in negative consequences to that individual and/or their profession. Instead of a “one-strike and you are out” approach, these organizations recognize that there is a disease process occurring. Thus, as opposed to engaging in strictly punitive measures, a rehabilitative approach is chosen to allow the health professional an opportunity to recover and successfully reenter into their profession. …