Medicine and Health Sciences Commons^™

The Emerging Oral Pathogen, Filifactor Alocis, Modulates Antimicrobial Responses In Primed Human Neutrophils., Ian J. Snider

College of Arts & Sciences Senior Honors Theses

Periodontitis is an irreversible, chronic inflammatory, infectious disease of the oral cavity that affects approximately half of all adults 30 years or older in the USA. The oral cavity is under high immune surveillance because of its constant exposure to microbes in the environment. The primary immune cell responsible for this surveillance is the neutrophil. Pathogens associated with periodontitis possess virulence factors and have evolved strategies to evade neutrophil antimicrobial responses to survive. One such pathogen is Filifactor alocis, whose presence is associated with the progression of periodontitis. F. alocis manipulates several neutrophil antimicrobial functional responses to avoid killing, an …

Impacts Of Dietary Restriction On A Drosophila Model Of Werner Syndrome, Eileen Sember

College of Arts & Sciences Senior Honors Theses

Werner syndrome (WS) is an autosomal recessive disorder that results in premature aging and occurs in 1 in 1,000,0000 to 1 in 10,000,000 people. In humans, WS is the result of mutations that render the WRN gene, that contains a helicase and an exonuclease domain, non-functional. Currently, there is no cure for WS in humans, making dietary and lifestyle interventions attractive for increasing the quality and longevity of lives. Diet restriction (DR) has been shown to extend the lifespan of several model organisms, including Drosophila melanogaster, making it a strong candidate for WS treatment. In this thesis, mutant flies …

Barriers And Facilitators Of Dairy Consumption Among Individuals With Metabolic Syndrome., Kofi Amoh-Mensah

Electronic Theses and Dissertations

About 35% of the United States adult population meets the criteria for metabolic syndrome, representing about 85 million individuals. Consuming dairy products protects against the development of the metabolic syndrome and protects against the development of complications associated with it. However, approximately 10% of the U.S. population meets the daily recommendation for dairy products. Information about the use of dairy products among people living with metabolic syndrome is relatively unknown, even though it will benefit them the most. About 49% of respondents met the guidance of three servings per day, and the most common facilitator was access to dairy products.

The Impact Of Kentucky’S Medicaid Expansion On Adult Coverage And Diagnosis Of Type 2 Diabetes Mellitus And Diabetic Peripheral Neuropathy, The Use Of Antihyperglycemics And The Role Of Social Determinants Of Health 2011-2018., Brian Mcroberts

Electronic Theses and Dissertations

Objectives: This study analyzed the impact of Medicaid expansion in Kentucky on coverage of adults aged 19-64 and the diagnosis of type 2 diabetes mellitus (T2DM) and diabetic peripheral neuropathy (DPN) and the use of antidiabetic medications or insulin (antihyperglycemics) for T2DM, controlling for Social Determinants of Health (SDOH). Method: This study assembled ICD-based claims and prescription drug NDC claims from all adult residents of Kentucky enrolled in Medicaid from 2011 to 2018. Three-digit zip code (Zip-3) data was appended to each case from the American Community Survey to provide SDOH variables. Tests performed included ANOVA, decision trees, varimax rotated …

An Analysis Of The Effects Of Certified Electronic Health Records On Organizations And Patients., Picandra Elzie

Electronic Theses and Dissertations

The growing technological advancement of electronic health records can become an issue with quality and electronic patient information exchange if hospitals do not adhere to federal guidelines. It is recommended that hospitals utilize certified electronic health records (EHRs) to receive financial incentives. This certification is supposedly also associated with the quality of the EHR itself. The certification process is criticized for allowing EHR vendors to meet a set of limited functions known in advance. EHRs can affect healthcare quality and electronic health information exchange. This dissertation explored what is known about the effects of certified EHRs on length of stay …

An Evaluation Of Hospital-Based Health Technology Assessment Processes In The United States., Scott Skinner

Electronic Theses and Dissertations

This research study explored the practices of hospital-based health technology assessment (HTA) in the U.S., as experienced by healthcare technology management (HTM) professionals. HTA can play an important role in helping to evaluate health technologies at both the macro (e.g., policy) level as well as at the micro (e.g., institutional) level of the public health ecosystem (C. S. Goodman, 2004). HTA seeks to broadly evaluate the effects, properties, and other impacts of various health technologies (C. S. Goodman, 2004). Common goals of HTA are to evaluate the safety, effectiveness, and cost-benefit of health technologies. A primarily phenomenological approach was used …

Toward A Comprehensive Account Of Orientation Selectivity In The Retina., Megan Zipperer

Electronic Theses and Dissertations

Retinal Ganglion Cells (RGCs) form functionally distinct signaling channels that selectively encode features of the visual input including direction of motion, contrast polarity, size, and color. A highly conserved visual channel amongst vertebrates conveys orientation selectivity, i.e., the selective firing of neuronal cells in response to elongated stimuli along a preferred orientation. Orientation selectivity is an apparent critical computation and several studies have reported aspects of it, including cell type identity in anatomical reconstructions, and functional characterization of at least four different identified RGC types. But how cell types in the different studies relate is not well resolved; the mechanisms …

Factors Associated With Skin Cancer Prevention: Primary And Secondary Behaviors., Jeanne Ward

Electronic Theses and Dissertations

Skin cancer, seemingly more innocuous than other cancers, maintains the highest incidence among cancers in the United States. While it is treatable early, metastasized melanoma or other carcinomas present severe illness with high mortality rates and disproportionate 5-year survival rates among ethnic/racial groups. Fortunately, most skin cancer is highly treatable when found in the early stages. However, this necessitates prevention tactics to avoid the causative agent, ultraviolet radiation, and regular skin screening to catch the disease in earlier stages. Unfortunately, these tactics are not widely conducted by adults, despite substantial skin cancer awareness. Therefore, motivating people to perform these health …

Adverse Birth Outcomes: Investigating The Role Of Nativity And Perceived Racial Discrimination Among Black Mothers Enrolled In Des Moines, Iowa Healthy Start., Kendria Kelly-Taylor

Electronic Theses and Dissertations

Birth outcomes for Black women in the United States (US) are disproportionately worse in comparison to non-Black women, even when controlling for potential confounders. Existing studies suggest foreign-born (FB) Black women present better birth outcomes in comparison to US-born (USB) Black women. Also, the longer FB Black women live in the US, the more their perinatal health advantage diminishes. Racial discrimination has been hypothesized as a potential reason for this decline. This dissertation investigates the relationship between nativity and adverse birth outcomes while also exploring how the reporting of racial discrimination impacts birth outcomes among FB and USB Black mothers …

Irreversible Electroporation Potentiates Beta Glucan Induced Trained Innate Immunity: A Novel Combination Treatment For Pancreatic Adenocarcinoma., Matthew Woeste

Electronic Theses and Dissertations

Pancreatic cancer (PC) is a challenging diagnosis yet to benefit from advances in immune oncologic treatments. Irreversible electroporation, a non-thermal method of tumor ablation, is used in treatment of select patients with locally advanced unresectable PC and has potentiated the effect of certain immunotherapies. Yeast-derived particulate β-glucan induces trained innate immunity and successfully reduces murine PC tumor burden. This study tests the hypothesis that IRE may augment β-glucan-induced trained immunity in the treatment of PC. β-Glucan-trained pancreatic myeloid cells were evaluated ex vivo for trained responses and anti-tumor function after exposure to ablated and un-ablated tumor conditioned media. β-Glucan and …

Our Story, Our Song: Assessing And Addressing Black Women's Healthcare Experiences., Jason Deakings

Electronic Theses and Dissertations

Despite advancements in medicine and health sciences, health disparities and declining life expectancy persists among Black women in the United States. Researchers and non-traditional healthcare providers suggest alternative healing (e.g., music and Sister Circles) and research methodologies to achieve a culturally conscious, traumainformed, quality, and holistic care and practice. The intersecting identities and cultural responsibility of Black women highly influences the barriers and facilitators on the uptake of healthcare services. Utilizing a community engaged research approach, this qualitative study assessed the healthcare experiences, as well as the role of music in the lived and retold experiences of Black women navigating …

Postpartum Depression In Jamaica: Exploring The Lived Experiences., Shakeyrah Elmore

Electronic Theses and Dissertations

The purpose of this study was to explore the lived experiences of Jamaican women with postpartum depression (PPD). It is estimated globally, postpartum depression impacts 10-20% of women. In Jamaica, rates exceed global averages, with 26-60% of women experiencing PPD. Untreated maternal depression poses a significant physical, social, and economic threat to Jamaican women, children, and society as a whole. This study affirms that maternal mental health and postpartum depression are global public health concerns. There are limited studies that have examined PPD in Jamaican women, especially qualitatively. This research study utilized a qualitative descriptive approach to examine PPD experiences …

The Association Of Long Working Hours And The Use Of Prescription Sedatives Among U.S. Workers., Emmanuel Ezekekwu

Electronic Theses and Dissertations

BACKGROUND: Meeting the needs of a round-the-clock and globalized society has led to an increase in long working hours. This trend has been accompanied by a corresponding rise in sleep disorders and subsequent use of sedating medications. Overtime hours have been associated with adverse health outcomes such as cardiovascular diseases, symptoms of psychological distress, and health behaviors, including risky intake of alcohol and smoking. Hence, the main objectives of this three-paper dissertation were to examine the multi-faceted relationship between working hours, the use of prescription sleep aids, the onset of psychological distress, and the use of health care services. METHODS: …

Self-Perceived Well-Being Among Doctor Of Physical Therapy Students In The United States, David Kietrys, Ellen Anderson, Suchismita Ray

Journal of Wellness

Introduction: The purpose of this study was to describe self-perceived well-being among Doctor of Physical Therapy (DPT) students in the United States during the COVID-19 pandemic and explore factors associated with well-being.

Methods: This observational study was cross-sectional, using an anonymous, self-administered, nationwide survey. The survey included questions about an array of factors theoretically related to well-being, and incorporated the WHO-5 Well-being Index, the Perceived Stress Scale-10, and the Brief Resiliency Scale.

Results: A total of 1,542 responded to the survey. Data from 1,537 DPT students in the U.S. were included in the analysis. Well-being was positively correlated with resilience …

Wellness Review 2022, Part 2, Martin Huecker, Brian A. Ferguson, Jacob Shreffler

Journal of Wellness

Introduction: Similar to prior reviews, the Journal of Wellness editors searched the literature from the second half of 2022 for an interesting and impactful selection of publications on wellness in healthcare professionals.

Methods: Editors conducted a standard keyword search in Pubmed, focusing chiefly on large journals, interventional trials, and other prospective research. We included papers published between July 1, 2022 and December 31, 2022.

Literature in Review: Finding several hundred publications, we excluded editorials, reviews, and some smaller, less generalizable papers. A final 25 significant studies focusing on wellness in medical professionals were sorted into the following categories: logistics, creativity …

Covid-19 Coagulopathies: Highlights Of 2020–2021 Reported Data, Shreya Anil Kumar, Anushka Pradhan, Abdelrahman Elsebaie, Karina Fainchtein, Abdelrahman Noureldin, Yousra Tera, Sajida Kazi, Maha Othman

The University of Louisville Journal of Respiratory Infections

Background: The COVID-19 pandemic has evolved dramatically over the past two years, and literature on COVID-19 coagulopathy has been overwhelming, which complicates the process of understanding the literature or assessing the quality of the data available. The objective of this narrative review was to highlight and analyze data reported on COVID-19-induced coagulopathy and its outcomes in patients with severe or critical disease over two years of the pandemic.

Methods: Studies published in high-impact journals reporting on hospitalized adult COVID-19 patients, their coagulation parameters, and their thrombotic complications were included. We searched MEDLINE, Embase, and Ovid between Dec 1, 2019 and …

Emergency Medicine In-Training Examination Scores Are Not Associated With Burnout And Not Affected By The Introduction Of A Wellness Curriculum, Kelly Williamson Md, Patrick M. Lank, Nicholas Hartman, Nathan Olson, Elise O. Lovell

Journal of Wellness

Introduction: There is little research examining the relationship between burnout and medical knowledge. Study Objectives: The authors sought to determine if emergency medicine (EM) resident performance on the In-Training Examination (EM-ITE) is associated with burnout and if EM-ITE scores are affected by the implementation of a wellness curriculum.

Methods: As part of a multi-institution prospective education intervention trial, the Maslach Burnout Inventory, a valuable tool in the assessment of physician burnout, was administered at 10 EM residencies in February 2017. Then, five intervention sites introduced a year-long wellness curriculum. The MBI was re-administered at all sites in August 2017 and …

Survey Of Nutrition Education Among Medical Students, Michael P. Duggan, Anahita T. Kodali, Zach A. Panton, Shannon M. Smith, Grant J. Riew, Jack F. Donaghue, Gregory A. Leya, Logan G. Briggs

Journal of Wellness

Introduction: The current literature regarding both specific interventions and the current level of nutrition education in the United States is scarce. The purpose of this paper is to provide medical student perspectives on both the degree and necessity of nutrition education during medical school.

Methods: Medicine in Motion (MM) is a non-profit student-run organization founded in 2018 that aims to address burnout in medicine through physical activity, community service, and philanthropy. MM issued a survey to nine of its chapters in January 2021 to assess a range of topics including burnout, physical activity, and nutrition education.

Results: Of 5500 invited …

Peer-Supervision Of Nursing Professionals: A Shield Against Burnout, Kyle Gamache, Sarah Gamache, Joseph Robillard

Journal of Wellness

Introduction: Burnout is a major risk in healthcare professions and is a significant contributor to the current nursing shortage. Strategies to combat burnout of healthcare professionals are in desperate need. The purpose of this project is to introduce the clinical peer supervision model as a method to alleviate burnout in nursing professionals.

Approach: Eight nurses from in-patient settings participated in a peer-supervision support group, modeled after existing European nursing and mental health provider-support protocols. To assess the effect of this intervention, qualitative data analysis was conducted on the transcripts of session and the results described. All participants reported statistically high …

Does Positive Psychology Coaching Improve Trainee Well-Being? Evidence From A Longitudinal Professional Development Coaching Program In A Cohort Of Pediatric Trainees, Benjamin Nelson, Jacqueline T. Chu, Michael G. Healy, Yoon Soo Park, Kerri Palamara Md

Journal of Wellness

Introduction: Trainee burnout is common and evidence supporting the effectiveness of well-being interventions for this population is limited. We studied the effect of a longitudinal coaching program grounded in positive psychology on measures of pediatric trainee well-being.

Methods: Pediatric interns and fellows (n = 67) were enrolled in a positive psychology coaching program in 2017-2019. Pediatric faculty (n = 23) underwent training and were paired with trainees outside their field of interest. Trainees were surveyed at the beginning and end of the program to assess burnout and well-being, and key skills necessary to achieve well-being.

Results: Thirty-one …

Variable Shift Lengths Negatively Affect Emergency Medicine Resident Wellness, Marcus Fazzari, Joseph Longobardi, Joseph Mccarthy, Matthew Hysell, Sidney Hann

Journal of Wellness

Introduction: Burnout is very common in emergency medicine and there has been extensive research evaluating factors that contribute to burnout. We sought to examine the contributions of post-graduate year (PGY), shifts worked per month, patients seen per shift, and length of shifts to emergency medicine resident burnout.

Methods: All emergency medicine residents were surveyed with regards to their PGY, shifts worked per month, patients seen per shift, and length of shifts. They were administered the Stanford Wellness Survey and asked to globally rate their degree of burnout. We then modeled whether consideration of the surveyed factors increased the …

Anatomy Lab, Brian R. Smith

Journal of Wellness

No abstract provided.

Performance Of A Sars-Cov-2 Rt-Pcr Assay With Non-Traditional Specimen Types, Subathra Marimuthu, Holly Aliesky, Heather Ness, Daniya Sheikh, Sathya Rashmit, Dawn Balcom, Leslie A. Wolf

The University of Louisville Journal of Respiratory Infections

During the first two years of the coronavirus disease 2019 (COVID-19) pandemic, nasopharyngeal (NP) specimens were the gold standard for clinical diagnostic testing. As information about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing the pandemic continued to be shared, it was clear that the virus could be detected in other specimen types during an active infection. The University of Louisville Infectious Diseases Laboratory accepted non-traditional specimen types, most without a paired, positive NP result, for research purposes only to support local epidemiology efforts. A real-time reverse transcription-polymerase chain reaction (RT-PCR) assay originally validated for NP specimens was used …

What? Now A Respiratory Syncytial Virus Epidemic, Aya Allam, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

A Focused Review Of Multidimensional Well-Being Assessments, Samantha Schonhardt, Stephanie Sullivan, Rebecca Shisler Marshall

Journal of Wellness

Introduction: Interest in the topic of well-being continues to grow and has resulted in the creation of a variety of well-being assessments. However, each assessment often brings its own terminology, theories, definitions, and dimensions. This creates a muddled research base that produces inconsistencies in the field of well-being. Therefore, the aim of this review was to identify assessments that measure multiple dimensions of well-being, catalogue and group the dimensions into categories, and develop definitions for the categories based on the conceptualizations in the literature. In doing so, the dimensionality of well-being portrayed in the literature can be better understood. …

Factors In Primary Care Use Among Young Adult Refugees From Burma And Bhutan In Early Resettlement: Findings From Colorado, Sarah Brewer, Jini Puma

Journal of Refugee & Global Health

Background: Young adult refugees have suboptimal primary care use in early resettlement—domains of integration influence primary care engagement during this time.

Methods: Adjusted logistic regression models were used to estimate odds of (1) having a primary care exam and (2) identification of a primary care provider (PCP) as predicted by domains of integration among young adult refugees (n=154) from Burma and Bhutan across four years following resettlement.

Results: Overall integration and predisposing factors, such as language and cultural knowledge, were lower odds of having a primary care provider. Enabling factors such as having insurance and knowing how to make an …

Assessing The Efficacy Of A Meditation Intervention On Dispositional Mindfulness Among Medical Students And Resident Physicians, Kelsey Stefan, Michael Villeneuve, Varun Konanki, Erica Rarity, Rahul Mhaskar, Liwei Chen, Amelia Phillips

Journal of Wellness

Introduction: Dispositional mindfulness is the act of paying attention to one’s thoughts and feelings with an open and non-judgemental attitude. Medical students and resident physicians are under immense pressure and stress daily, and they need effective tools to help increase their dispositional mindfulness. This project examined the impact of a meditation intervention on medical students’ dispositional mindfulness.

Methods: In 2020, medical students and resident physicians at the University of South Florida were given the option to practice daily meditation for thirty days; time spent on the practice varied depending on comfort with the practice. Dispositional mindfulness levels were assessed using …

Investigating Stigma During The Early Stages Of A Pandemic Through The Lens Of Covid-19, Zach Thornton, Bethany Hodge, Sheridan Langford

The University of Louisville Journal of Respiratory Infections

Background: Individuals face stigma associated with numerous health conditions. Stigma can arise rapidly during the early spread of a new disease, adding to the burden felt by those affected. COVID-19 can be used as an example to study stigma during the early phases of a pandemic. This narrative review is a descriptive analysis that tracks the ways in which COVID-19 stigma was discussed in the scholarly literature during the first year of the pandemic to understand how stigma was viewed in the context of a rapidly spreading pandemic.

Methods: PubMed was used as a non-exhaustive sample of the literature. Searches …

Retrospective Evaluation Of Depression Screening Process Among Older Adult Patients In Primary Care For Quality Improvement., Ashley Dru Larson

Doctor of Nursing Practice Papers

Background: Depression is not a normal process of aging; it is a diagnosable and treatable medical condition. The US Preventive Services Task Force (USPSTF) recommends that older adults be screened for depression annually.

Aim: The purpose of this evidence-based practice (EBP) project was to evaluate the depression screening process for older adults (age 65+) in a primary health care setting and provide recommendations to the primary health care clinic for improving it.

Methods: This EBP project involved collecting retrospective data from August to October 2022, including aggregate data (demographics), from all older adults who were seen in …

Who Leads The Emergency Department Debrief?, Allison D. Lane, Ethan Bryce, Marcy R. Milbrandt, Lisa R. Stoneking

Journal of Wellness

No abstract provided.