Medicine and Health Sciences Commons^™

Associations Between Physical Activity Levels And Physical And Mental Health In Military Veterans., Troy Hubert

Theses and Dissertations--Psychology

Research suggests that higher rates of health conditions are associated with lower levels of physical activity, but this association is not well characterized in U.S. Military Veterans. The current study utilized a sample of U.S. military veterans (n = 3,989) from the 2019-2020 National Health and Resiliency in Veterans Study (NHRVS). Physical activity levels (insufficient, moderate, and active), physical and mental health were evaluated with a variety of self-report questionnaires. After controlling for covariates, veterans with any disability, asthma, chronic pain, diabetes, high cholesterol, and stroke were significantly less likely to report sufficient physical activity compared to insufficient physical …

Aggravated Ulcerative Colitis Via Circnlgn-Mediated Suppression Of Nuclear Actin Polymerization., William W Du, Chi Zhou, Hui Yang, Shuoyang Wen, Yu Chen, Eric X Chen, Xiuwei H. Yang, Feiya Li, Kevin Y Du, Hui Yuan, Ting Ye, Javeria Qadir, Burton B Yang

Pharmacology and Nutritional Sciences Faculty Publications

Colitis is a chronic bowel disease characterized by damage to the lining of the large intestine, with its precise underlying causes remaining incompletely understood. In this study, we provide evidence that circular RNA circNlgn plays a pivotal role in promoting the development of colitis. Colitis patients produce significant higher levels of circNlgn. Transgenic mice expressing circNlgn exhibit heightened susceptibility to colitis development and progression, primarily attributed to the presence of the protein isoform Nlgn173 encoded by circNlgn. Nlgn173 undergoes translocation into cell nuclei, where it interacts with actin, impeding the binding of actin-related protein 2 and 3 (Arp2/3) complex to …

Characterizing The Relationship Between The Presence Of Depression Risk, Post-Traumatic Stress Disorder, And Benzodiazepine Use To Get High, Julia Kollitz

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

Aim: To determine if there is a relationship between depression risk, post-traumatic stress disorder (PTSD), and engaging in benzodiazepine misuse.

Methods: A secondary cross-sectional analysis was conducted on data from a sample of people who use drugs (n=743). Depression risk was assessed via the Center for Epidemiological Studies-Depression scale. Meeting DSM-IV criteria for PTSD was identified using the Mini International Neuropsychiatric Interview (MINI). We used simple and multivariable logistic regression models to estimate the association between mental health factors of interest and benzodiazepine misuse, defined as self-reported benzodiazepine use “to get high” in the past six months.

Results: Of the …

A Case Study In Program Evaluation: A Prospective Program Evaluation Of Timely Reporting And Action Of An Infectious Disease Outbreak, Destiny Cozart

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

Methicillin-resistant Staphylococcus aureus also known as MRSA is an infection of a staph bacteria. High school athletes are at risk of contracting MRSA through skin to skin contact and/or MRSA contaminated equipment. This case study uses the CDC's six-step framework for program evaluation to measure the effectiveness of the online training modules designed to increase the knowledge of staff and stakeholders about MRSA and infectious disease outbreaks. The findings from this evaluation will advise the potential change(s) implemented in training modules, ultimately to enhance competency for decision makers and prevent MRSA and infectious disease outbreak amongst high school athletic programs.

Prevalence Of Hpv16 E6 Antibodies And Oral Hpv Among Men Living In Kentucky, Christopher O. Otieno

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

ABSTRACT

Objective: The incidence of human papillomavirus-driven oropharyngeal cancer (HPV-OPC) is surging in the United States, particularly in the southeast and Appalachia. The reason for this increase is unknown. We evaluated the prevalence of two markers of increased risk, HPV16 E6 antibodies and oral HPV infection, among men in Appalachian and non-Appalachian Kentucky.

Methods: This study was nested within an ongoing HPV-OPC screening study of healthy men aged 45+ residing in urban (non-Appalachian) and rural (Appalachian) Kentucky and included the first 1,581 participants with either HPV serologic and/or oral HPV testing. Blood and oral rinse samples were collected at enrollment. …

Dental Outreach In Academic Dental Settings, Tisha Clayborn

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

Creating an effective outreach program in a dental academic setting involves a strategic approach combining educational objectives and community service. This Dental Outreach Program Guide aligns with organizational objectives, contributes to community well-being, and serves as a model for future outreach initiatives in academic dental settings. This program utilizes the PRECEDE-PROCEED planning model to design and evaluate an oral health strategy. This program aims to outline a strategic plan incorporating evidence-based decision-making, data-driven metrics, and a comprehensive roadmap for successful implementation.

Fall 2023 Covid-19, Influenza, And Respiratory Syncytial Virus Vaccine Uptake In Kentucky, Abigail Dial

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

Fall 2023 COVID-19, Influenza, and Respiratory Syncytial Virus Vaccine Uptake in Kentucky

Background: In the fall of 2023, vaccine recommendations included updated COVID-19 and influenza vaccines, as well as a new vaccine and immunization for respiratory syncytial virus (RSV). Vaccine co-administration, the administration of more than one vaccine in one vaccination session, is safe and effective for COVID-19, influenza, and RSV vaccines and can improve vaccine uptake for all recommended vaccines (Bonanni, et al., 2023; CDC, 2023). The COVID-19 pandemic altered the landscape for locations where people receive vaccinations, and it may be beneficial to public health to have …

Investigating The Use Of Serious Games For Cancer Control Among Children And Adolescents: Scoping Review, Sunghak Kim, Ebling Library, Olufunmilola Abraham

Pharmacy Practice and Science Faculty Publications

Background: Effective health care services that meet the diverse needs of children and adolescents with cancer are required to alleviate their physical, psychological, and social challenges and improve their quality of life. Previous studies showed that serious games help promote people’s health. However, the potential for serious games to be used for successful cancer control for children and adolescents has received less attention.

Objective: This scoping review aimed to map the use of serious games in cancer prevention and cancer care for children and adolescents, and provide future directions for serious games’ development and implementation within the context of cancer …

Biodegradable Nanoparticles Targeting Circulating Immune Cells Reduce Central And Peripheral Sensitization To Alleviate Neuropathic Pain Following Spinal Cord Injury., Michael N. Saunders, Kate V. Griffin, Irina Kalashnikova, Daniel Kolpek, Dominique R. Smith, Eiji Saito, Brian J. Cummings, Aileen J. Anderson, Lonnie D. Shea, Jonghyuck Park

Pharmaceutical Sciences Faculty Publications

Neuropathic pain is a critical source of comorbidity following spinal cord injury (SCI) that can be exacerbated by immune-mediated pathologies in the central and peripheral nervous systems. In this article, we investigate whether drug-free, biodegradable, poly(lactide- co -glycolide) (PLG) nanoparticle treatment mitigates the development of post-SCI neuropathic pain in female mice. Our results show that acute treatment with PLG nanoparticles following thoracic SCI significantly reduces tactile and cold hypersensitivity scores in a durable fashion. Nanoparticles primarily reduce peripheral immune-mediated mechanisms of neuropathic pain, including neuropathic pain-associated gene transcript frequency, transient receptor potential ankyrin 1 nociceptor expression, and MCP-1 (CCL2) chemokine …

Elucidating The Role Of Fatty Acid Synthase In Apc-Driven Colorectal Cancer, Courtney O. Kelson

Theses and Dissertations--Toxicology and Cancer Biology

Globally, colorectal cancer (CRC) is the second leading cause of cancer related deaths. Currently, there is a growing incidence rate for individuals aged 20-49 years. Genetic and environmental factors contribute to the risk of this cancer. Early detection of CRC allows for the most effective treatment option in which surgical resection of the primary tumor occurs along with adjuvant chemotherapy. This therapeutic approach contributes to 5-year survival rate of 91%. However, surgical procedures and chemotherapy struggles against metastatic and relapsed CRC resulting in 5-year survival rate of 14%. Inefficacious treatments for relapsed and metastatic diseases emphasizes the need for more …

Understanding The Mechanism Of Ferroptosis Susceptibility Variation In Colorectal Cancer, Aziza Alshahrani

Theses and Dissertations--Toxicology and Cancer Biology

Colorectal cancer (CRC) is the second leading cause of cancer-related death worldwide. Despite the use of chemotherapeutic agents, CRCs remains to be difficult to cure at least partially due to their intrinsic and/or acquired resistance to cell death inducers. Ferroptosis is a form of regulated cell death that caused by the accumulation of lipid peroxides. Studies have shown that dysregulation of ferroptotic pathways is associated with the development of resistance to various cancer treatment. Glutathione peroxidase 4 (GPX4) is a known target for inducing ferroptosis due to its critical role in detoxifying lipid hydroperoxides, and ferroptosis suppressor protein (FSP1) also …

Redefining Ed Utilization: A Rabies Post-Exposure Prophylaxis Perspective, David Bennington

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

Rabies, though rare in the United States, remains a lethal viral disease with significant public health implications. Post-exposure prophylaxis (PEP) through timely administration of rabies vaccines and rabies immune globulin (RIG) is critical for preventing the progression of the virus following potential exposure. However, the current system of healthcare delivery in the United States has witnessed an alarming trend: the unnecessary utilization of emergency department (ED) visits for rabies PEP, including follow-up vaccinations. This paper aims to examine and address this issue through a review of the factors contributing to the inappropriate use of ED services for rabies treatment.

Through …

Zebrafish Drug Screening Identifies Erlotinib As An Inhibitor Of Wnt/ Β-Catenin Signaling And Self-Renewal In T-Cell Acute Lymphoblastic Leukemia, Majd A. Al-Hamaly, Anna H. Cox, Meghan G. Haney, Wen Zhang, Emma C. Arvin, Shilpa Sampathi, Mary Wimsett, Chunming Liu, Jessica S. Blackburn

Markey Cancer Center Faculty Publications

The Wnt/β-catenin pathway’s significance in cancer initiation, progression, and stem cell biology underscores its therapeutic potential. However, the clinical application of Wnt inhibitors remains limited due to challenges posed by off-target effects and complex cross-talk of Wnt signaling with other pathways. In this study, we leveraged a zebrafish model to perform a robust and rapid drug screening of 773 FDA-approved compounds to identify Wnt/β-catenin inhibitors with minimal toxicity. Utilizing zebrafish expressing a Wnt reporter, we identified several drugs that suppressed Wnt signaling without compromising zebrafish development. The effi- cacy of the top hit, Erlotinib, extended to human cells, where it …

A Case Study In Prospective Program Evaluation, Sarai Rosemary Combs

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

Evaluation is a helpful tool in public health to provide transparency about community interventions and programs. The following is a prospective evaluation of a case study, looking at a recently designed program by the Lexington-Fayette County Health Department, as a capstone project for the Health Management and Policy concentration of the Masters in Public Health program of the College of Public Health. The health department developed a series of online training modules to increase knowledge of Methicillin-resistant staphylococcus aureus (MRSA) and other similar organism outbreaks and how to respond to these outbreaks. The program targets were Fayette County Public School …

Characteristics Of Congenital Syphilis Cases In Kentucky 2019-2023, Ines Roy

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

Abstract:

Background: The incidence of congenital syphilis (CS) has increased both in the United States (US) and globally and remains a public health concern. In Kentucky alone, there has been a significant increase in CS cases, from 9 cases in 2019 to 27 cases in 2023. CS is a preventable disease, but testing and immediate treatment are critical to prevent its spread. We have limited knowledge regarding Kentucky’s characteristics and behavioral factors that may be associated with this rise. The goal of this study is to identify characteristics and potential risk factors that contribute to the rise of CS in …

The Distribution Of Cp-Cre Cases From 2013-2020 In The Commonwealth Of Kentucky, Hannah Hiscox

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

Multidrug-resistant organisms (MDROs), particularly Carbapenem-Resistant Enterobacterales (CRE), pose a significant threat to public health due to their resistance to multiple antibiotics, including carbapenems. CRE infections, especially those producing carbapenemases (CP-CRE), are associated with high morbidity and mortality rates, making them a growing concern in healthcare settings. Despite the prevalence of CRE infections in the United States, limited data exist on the incidence and distribution of CP-CRE infections in specific regions, such as the Appalachian counties of Kentucky.

This study aimed to investigate the cumulative incidence and distribution of CP-CRE cases in Appalachian and non-Appalachian counties of Kentucky, as well as …

A Case Study In Program Evaluation, Iantha Wright

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

The framework for program evaluation is a systematic way of improving and accounting for public health actions by providing practical, feasible, ethical, and accurate information. As a practical, non-prescriptive tool, it guides public health professionals through the essential steps in program evaluation. The framework uses the six steps to understand how to improve and conduct assessments effectively. Additionally, it emphasizes integrating stakeholders and using ongoing evaluation strategies to plan effective interventions, improve existing programs, and demonstrate the efficient use of resources.

Demographic And Behavioral Characteristics Of People Who Help Others Inject Drugs: A Study Of People Who Inject Drugs In Appalachia Kentucky, Ryli Hockensmith

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

Aim: This study aims to understand the demographic and behavioral characteristics of people who inject drugs (PWID) who assist others with injection, hereafter “injection assistors,” and assess the characteristics of injection assistors compared to PWID who do not assist others with injection in Appalachian Kentucky.

Methods: A cross sectional secondary data analysis of data collected from 433 PWID enrolled in the ongoing Kentucky Outreach Service (KyOSK) was performed. Logistic regression analyses were performed to compare injection assistors to those who do not assist others on demographic, behavioral, service usage, and harm reduction characteristics.

Results: In total, 128 (29%) PWID reported …

Mail-Based Or Home Delivery Services: Preferences Among People Who Inject Drugs In Appalachian Kentucky, Su Su Zin

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

Aim: To explore acceptability of delivery-based syringe services program (SSP) among people who inject drug (PWID) in Eastern Kentucky and compare those who wanted to participate in delivery-based SSP to those who did not.

Methods: This was a cross-sectional analysis of data from PWID who injected drugs to get high in the past 30 days (n=246) collected during the baseline assessment administered to the Gateway2Health cohort. Chi-square tests, t-tests, univariate and multivariable logistic regressions were calculated between independent variables and the outcome variable (likelihood of participating in a delivery-based SSP).

Results: 52.9% of PWID reported being likely to participate in …

Human Papilloma Virus Type 16 Seroprevalence Among Men Living With Hiv, Ashley Duff

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

Objectives: Individuals living with HIV are at a higher risk for developing human papillomavirus-driven oropharyngeal cancer (HPV-OPC). There are no methods for early detection; however, HPV16 E6 antibodies have been identified as a promising early marker. The objective of this study was to evaluate seroprevalence and predictors of HPV16 E6 seropositivity among men living with HIV.

Methods:2,334 men aged 40+ living with HIV with blood specimens banked within the Tennessee Center for AIDS Research (TN-CFAR) biorepository were evaluated using HPV multiplex serology. Seroprevalence of HPV16 antibodies was calculated for all HPV16 proteins analyzed (L1, E1, E2, E4, E6, E7). …

A Case Study In Program Evaluation, Sierra L. Williams

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

The Lexington-Fayette County Health Department (LFCHD) developed an education program targeted toward infectious disease outbreaks. The program ensures timely reporting and action during an infectious disease outbreak within the Fayette County Public Schools (FCPS) system. I have been tasked with evaluating the program and its implementation of training modules through pre and post-surveys to determine if the program is significantly increasing the overall knowledge of program participants and make recommendations for how program aspects can be improved.

Program Evaluation Case Study, Grace Mullikin

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

Program evaluation case study utilizing Center for Disease Control and Prevention's Case Evaluation Framework.

The Health Literacy Practices Of Rehabilitation Providers Of Perioperative Orthopedic Education, Allen Keener

Theses and Dissertations--Rehabilitation Sciences

Health literacy is the ability to utilize information to make decisions about one’s health or the health of others. It is estimated that a large percentage of the population has inadequate health literacy, yet healthcare professionals, including rehabilitation providers often do not have procedures in place for assessing and addressing the health literacy of their patients. Related to orthopedic patients, a large portion of the interventions are educational in nature. Therefore, it is important that the health literacy of orthopedic patients be considered when addressing their needs perioperatively. There is little currently published related to health literacy among rehabilitation providers …

An Uncultivated Skillset: Emotional Intelligence In Healthcare Profession Students, Molly Taylor

Theses and Dissertations--Rehabilitation Sciences

Burnout and social isolation have become critical threats to optimal health and well-being, with detrimental effects specifically impacting healthcare profession (HCP) students and providers. The US Surgeon General has labelled burnout a crisis in the health workforce and named loneliness an epidemic with profound consequences for mortality and collective longevity. HCP students are heavily and disproportionately affected by stress and burnout compared to their peers, resulting in negative consequences on academic performance, mental health, empathy, and compassion satisfaction. Emotional Intelligence (EI) is a learnable skillset shown to protect against burnout and enhance relational skills, well-being, personal and professional satisfaction, and …

Equestrian Activities And Health Outcomes: A Multidimensional Analysis Of Physical Activity, Injury Patterns, And Occupational Concerns, Michaela Keener

Theses and Dissertations--Rehabilitation Sciences

Over 6 million participate in equestrian activities each year. However, research focusing on the benefits and risks around equestrian activities is limited to epidemiological research and small sample sizes. Equestrian participation ranges from recreational to occupational, and little research has evaluated how the risks of participation change based on the level of participation. Special consideration needs to be given to the occupational equestrians as equestrian participation is their livelihood. The first two aims of this study were to evaluate the physical activity engagement, perceptions of equestrian as a sport, acute injury history, and chronic pain frequency of equestrians across all …

The Effect Of Adding Perceptual-Cognitive Load To Assessments And Intervention Strategies In Healthy Adults, Ke'la H. Porter

Theses and Dissertations--Rehabilitation Sciences

In collegiate athletes, approximately one in four injuries require more than seven days before the athlete can return to full participation. Additionally, there are significant long-term consequences associated with these injuries, such as pain and osteoarthritis. Despite the role that the sensorimotor system and cognitive function play in athletic competition, the interaction between these systems in relation to sport-related injury is commonly overlooked. The sensorimotor system integrates and processes sensory, motor, and central mechanisms to produce a motor response. Further, cognition constructs, such as visual attention or processing speed, allow athletes to navigate the chaotic sporting environment. When there are …

Physical And Psychosocial Factors Related To Firefighter Musculoskeletal Disorders, Jennifer Ellen Tinsley Kubala

Theses and Dissertations--Rehabilitation Sciences

Career firefighters must perform physically and psychologically challenging duties in unpredictable and dangerous conditions. Previous investigations have found that firefighters suffer nearly 4 times the recorded musculoskeletal disorders (MSD) and workplace injuries compared to private and public sector workers, and take approximately 1.5 days longer to return to normal work. Thus, the burden of firefighter MSD experiences has been a growing area of exploration. The few investigations that have concurrently examined physical and psychosocial consequences experienced by firefighters have found a positive relationship between increased occupational stress reports and MSD experiences. However, these investigations, as well as those that individually …

The Role Of Social Determinants Of Health On Patient Recovery After Critical Illness, Lindsey E. Fresenko

Theses and Dissertations--Rehabilitation Sciences

Patients who survive critical illness have a prolonged recovery which impacts their quality of life and outcomes. The sudden life changes from being critically ill may create or exacerbate social factors or needs also known as social determinants of health. Patients’ SDOH are defined as the environments in which we live, work and play that impact health outcomes. Patients’ SDOH impact their life in early recovery from changes in previous roles to their need for increased financial, physical and emotional support. During this early recovery, patients are often recommended to participate in rehabilitation to improve their physical function. Although, accessing …

Key To Success: A Comprehensive Examination Of Support Personnel In School-Based Speech-Language Telepractice, Hannah Douglass

Theses and Dissertations--Rehabilitation Sciences

In the school setting, the telepractice team primarily consists of the clinician and a support person known as a telefacilitator. Though telepractice is an accepted method for delivering school-based speech-language therapy, many barriers to the integration of telepractice as routine care persist. A major barrier is clinicians' acceptance of telehealth. However, there has been limited investigation of factors that influence clinician acceptance. Another barrier is related to support personnel. Telefacilitators have been shown to be an integral part of the telepractice program. Yet there are significant gaps in knowledge regarding the roles and responsibilities, staffing and management, and barriers/facilitators to …

A Mixed Methods Exploration Of Occupational Therapy Pratice And Multiple Sclerosis Specialization, Dana Alghadban

Theses and Dissertations--Rehabilitation Sciences

The aim of this dissertation is to increase the body of research of how occupational therapists can address multiple sclerosis rehabilitation through occupational therapy services. Multiple sclerosis is a neurodegenerative disease that creates challenges for individuals to engage in meaningful occupations and significantly affects many areas of their lives. Occupational therapists play a role in the rehabilitation process for people with multiple sclerosis by providing occupation-focused interventions that may improve the health and well-being of clients living with the disease. As a result of the unpredictability of symptoms experienced by this population, individualized approaches to addressing participation and occupational performance …