Medicine and Health Sciences Commons^™

The Role Of Apob-Containing Lipoproteins In Abdominal Aortic Aneurysm, Jing Liu

Theses and Dissertations--Pharmacology and Nutritional Sciences

Abdominal aortic aneurysm (AAA) is a devastating disease that exhibits permanent lumen expansion typically in the infrarenal aorta. AAA is prevalent among aged population, especially in males. Despite the incidence in women is lower, studies indicate the tortuosity is more severe and aortic rupture risk is higher in women. In most patients, AAA remains asymptomatic until it ruptures leading to sudden and fatal hemorrhage.

To date, there is no proven medical therapy that can prevent the expansion or rupture. Human observational studies implicate the presence of AAA is associated with both high plasma low-density lipoprotein-cholesterol (HDL-C) and low plasma high-density …

Servsafe® Exam: Student's Memory Retention Two Years Later, Laura E. Tincher

Theses and Dissertations--Nutrition and Food Systems

This study analyzed the memory retention of University of Kentucky Dietetic and Hospitality students as it relates to food safety and sanitation knowledge originally presented on the ServSafe® certification exam. Dietetic and hospitality students take the ServSafe® certification course during the sophomore year of their degree program, but they are responsible for the sanitation and food safety information throughout their entire program of undergraduate study. The final sample consisted of 25 participants, with 84% (n=21) in the Dietetics program and 16% (n=4) in the Hospitality, Management and Tourism program. The mean difference in total score, domain one, domain two, domain …

Mechanisms Of Therapeutic Resistance In Castration Resistant Prostate Cancer, Sarah Katherine Martin

Theses and Dissertations--Molecular and Cellular Biochemistry

Taxane based chemotherapy is an effective treatment for castration-resistant prostate cancer (CRPC) via stabilization of microtubules. Progression to castration-resistant prostate cancer is characterized by increased androgen receptor (AR), elevated intra-prostatic androgens and activated AR signaling despite castrate levels of androgens.

Previous studies identified that the inhibitory effect of microtubule targeting chemotherapy on AR activity was conferred by interfering with AR intracellular trafficking. The N-terminal domain (NTD) of AR was identified as a tubulin interacting domain that can be effectively targeted by the novel small molecular inhibitor, EPI. Taken together, this evidence provided the rationale that targeting AR nuclear translocation and …

Food Security Factors Affect Growth In Young Children In An Ecuadorian Indigenous Community, Whitney Jeannine Asher

Theses and Dissertations--Nutrition and Food Systems

Inadequate nutrition in preschool-aged children in an urban indigenous community outside of Santo Domingo, Ecuador has a negative impact on growth and development. Nutritional assessments have shown that children are underweight and that there are some effects of stunting and wasting in the population. This study was conducted to assess the extent of food security in this indigenous community in preparation for addressing two of the Millennium Development Goals for 2015: reducing the under-five child mortality rate by two-thirds and eradicating extreme poverty and hunger. An aim was to validate on-site assessment measures in this indigenous community regarding geographic circumstances, …

Nutritional Assessment Of Preschool Children In An Urban Ecuadorian Community, Elizabeth A. Bronner

Theses and Dissertations--Nutrition and Food Systems

Objectives: The goal of this project was to determine the nutritional needs of preschool age children to help guide intervention development. The research aims were 1) to examine and describe young child (ages one to five) nutritional status as it relates to key nutrients associated with stunting and wasting; 2) to determine what key macro- and micro-nutrient deficiencies (primarily iron and zinc) are associated with wasting and stunting.

Methodology:

Study sample: Sixty-seven families with children ages one to five who participating in routine health care clinic visits during the UK Shoulder to Shoulder Global health brigade visits.

Study …

Fruit And Vegetable Consumption Of Division I Collegiate Football And Volleyball Players Pre- And Post-Deregulation Of Snacks By The Ncaa, Emily Ludwig

Theses and Dissertations--Nutrition and Food Systems

The deregulation of snacks by the National Collegiate Athletic Association (NCAA) permits institutions to provide enhanced snacks incidental to participation. Athletes may now have the opportunity to improve their diet quality. The purpose of this research was to assess the consumption of fruits and vegetables as well as body composition of Division I collegiate athletes. The sample included 19 American football players and 8 volleyball players. Paired t-tests were performed to compare fruit intake, vegetable intake, and body fat percentage pre- and post-deregulation of snacks. Linear regression models were used to determine correlations between change in fruit intake and change …

Linking The Home And Neighborhood Food Environments Regarding Dietary Intake Among Rural Adolescents, Matthew James Saulnier

Theses and Dissertations--Nutrition and Food Systems

Home availability of both healthful and unhealthful foods may influence consumption among rural adolescent populations. In conjunction, the availability of food in an individual’s local food environment has the potential to significantly impact what is procured for the home and eaten away from the home. The purpose of this study was to determine how in-store food availability and parental purchases influences home availability and, ultimately, dietary intake among adolescents. This study measured perceived home availability, using the University of Minnesota Project EAT Survey, and dietary intake, using the NHANES Dietary Screener Questionnaire, of (n=28) adolescent participants in two Kentucky counties …

Tumor-Derived Proteins And Mitochondrial Dysfunction In Lung Cancer-Induced Cachexia, Julie B. Mclean

Theses and Dissertations--Physiology

Lung tumors secrete multiple factors that contribute to cachexia, a severe wasting syndrome that includes loss of muscle mass, weakness, and fatigue. 80% of advanced lung cancer patients experience cachexia, which cannot be reversed by nutritional interventions, diminishes response to and tolerance of cancer treatments, and increases morbidity and mortality. Despite a multitude of clinical trials, there are currently no approved treatments. This deficiency suggests that not all of the factors that contribute to cachexia have been identified.

Cancer is frequently accompanied by an increase in cyclooxygenase-2 (COX-2), a hallmark of inflammation. Clinical trials for COX-2 inhibitors have resulted in …

Diffuse Optical Measurements Of Head And Neck Tumor Hemodynamics For Early Prediction Of Chemo-Radiation Therapy Outcomes, Lixin Dong

Theses and Dissertations--Biomedical Engineering

Chemo-radiation therapy is a principal modality for the treatment of head and neck cancers, and its efficacy depends on the interaction of tumor oxygen with free radicals. In this study, we adopted a novel hybrid diffuse optical instrument combining a commercial frequency-domain tissue oximeter (Imagent) and a custom-made diffuse correlation spectroscopy (DCS) flowmeter, which allowed for simultaneous measurements of tumor blood flow and blood oxygenation. Using this hybrid instrument we continually measured tumor hemodynamic responses to chemo-radiation therapy over the treatment period of 7 weeks. We also explored monitoring dynamic tumor hemodynamic changes during radiation delivery. Blood flow data analysis …

Outcomes Associated With Blood Component Transfusion In Adult Trauma Patients, Allison R. Jones

Theses and Dissertations--Nursing

The purpose of this dissertation was to evaluate outcomes associated with blood component (BC) transfusion in adult trauma patients. Specific aims were to: 1) explore the relationship between traumatic injury, hemorrhage, and BC transfusion, focusing on consequences of the component storage lesion through presentation of a conceptual model; 2) systematically review research literature comparing outcomes of massively transfused major trauma patients based on ratios of BCs received; 3) evaluating the relationship between type of blood transfusion trauma patients received (whole blood versus BCs) and mortality likelihood after controlling for demographic and clinical variables; 4) evaluating the relationship between volume and …

Psychological Well-Being Among Breast Cancer Survivors: Factors That Influence Transition From Primary Treatment To Early Survivorship, Celestine G. Gochett

Theses and Dissertations--Nursing

Eudaimonic psychological well-being (PWB) refers to a lifelong process of purposeful engagement in goal-driven tasks or activities resulting in positive psychological functioning. These activities reflect autonomy, purpose in life, self-acceptance, personal growth, positive relations with others, and environmental mastery. While more women are surviving breast cancer, they face a multitude of late and long term physiopsychosocial challenges that result from being diagnosed and treated. Protective health effects associated with the experience of PWB can potentially mitigate ill-being and benefit overall health of breast cancer survivors (BCS). Adequate preparation by healthcare teams to transition them from primary treatment to early survivorship …

The Psychological Well-Being Of Men Diagnosed With Prostate Cancer, Lee A. Walmsley

Theses and Dissertations--Nursing

Prostate cancer (PC) affects one in eight men in North America and continues to be the most common site of cancer in males, especially among older men in Europe and the United States, and the second most common cancer worldwide. Prostate cancer is, after lung cancer, the most common cause of cancer-related deaths among men with an estimated 27,540 deaths in 2015.

The well-being of patients diagnosed with PC is a largely unexplored research area. Numerous factors likely impact men’s psychological well-being as they progress through the experience of managing PC. Among the various factors that may predict psychological well-being …

The Effect Of Β-Hydroxy-Β-Methylbutyrate (Hmb) Supplementation On Neuromuscular Performance Following Fatiguing Exercise In Healthy Subjects, Jordon W. Macht

Theses and Dissertations--Kinesiology and Health Promotion

Supporters of a nutritional supplement, β-Hydroxy-β-Methylbutyrate (HMB) supplementation, claim that it will increase the muscular strength gains and lean muscle mass gains seen during a resistance training program. It has been suggested that HMB supplementation does this by preventing muscle damage or by regenerating damaged muscle cell membranes. However, no research has evaluated the effect of HMB supplementation on low frequency fatigue. Therefore, the purpose of this study was to determine if three weeks of HMB supplementation could attenuate the effects of low frequency fatigue caused by eccentric muscle contractions of the tibialis anterior muscle. A total of 33 healthy …

Cardiovascular Disease Risk Factors In Structural Firefighters, Nicholas W. Trubee

Theses and Dissertations--Kinesiology and Health Promotion

This dissertation is composed of two manuscripts assessing cardiovascular disease (CVD) risk in structural firefighters. Study 1 compared traditional CVD risk factors and health-related behaviors between professional and volunteer firefighters. Online questionnaires were sent to approximately 4000 firefighters in the state of Kentucky. The results indicated that 90% of volunteer and 58% of professional firefighters were classified as moderate-to-high CVD risk. Volunteer firefighters were significantly (p < 0.001) older and more likely (p = 0.026) to be current cigarette smokers. The mean body mass index among all firefighters in the sample was 30.8 kg·m^-2. Nearly 60% of volunteer firefighters were obese. Obese firefighters were more likely (p < 0.05) to have been diagnosed as diabetic or pre-diabetes compared to overweight and normal weight firefighters. These results indicate that volunteer firefighters may be at a greater CVD risk compared to professional firefighters.

Study 2 investigated the association of cardiorespiratory fitness (CRF) and body fat with arterial stiffness in professional firefighters. Forty-six …

Uterine Artery Rupture, An Angiopathy Of The Reproductive System Of The Mare: Occurrence And Potential Effects, Ana G. Toro Mayorga

Theses and Dissertations--Veterinary Science

The intent of this research was to identify if the degenerative changes within arteries in the endometrium (endometrial angiopathies) correlate with degenerative changes in the uterine arteries and can be used as a predictor of increased risk for uterine artery rupture (UAR). With this objective specimens from 20 mares that died from uterine artery rupture and 21 control mares that died from unrelated causes were obtained from cases submitted to the University of Kentucky Veterinary Diagnostic Laboratory (UKVDL) over a two-year period. Postmortem specimens of each mare were collected from the left and right uterine arteries at the origin, bifurcation, …

Surface Functionalized Magnetic Nanoparticles For Cancer Therapy Applications, Robert J. Wydra

Theses and Dissertations--Chemical and Materials Engineering

Despite recent advances, cancer remains the second leading cause of deaths in the United States. Magnetic nanoparticles have found various applications in cancer research as drug delivery platforms, enhanced contrast agents for improved diagnostic imaging, and the delivery of thermal energy as standalone therapy. Iron oxide nanoparticles absorb the energy from an alternating magnetic field and convert it into heat through Brownian and Neel relaxations. To better utilize magnetic nanoparticles for cancer therapy, surface functionalization is essential for such factors as decreasing cytotoxicity of healthy tissue, extending circulation time, specific targeting of cancer cells, and manage the controlled delivery of …

Saving Our Sisters: Effects Of A Computer-Based Version Of Sista On The Hiv-Related Behaviors Of African American Women, Krystal Frieson

Theses and Dissertations--Educational, School, and Counseling Psychology

Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) are infectious diseases wreaking irreparable havoc on the lives of millions all around the world. Of those infected and affected by HIV in the United States, African Americans disproportionately bear the burden of this disease, which has resulted in a major crisis within the African American community. In 2010, African Americans accounted for approximately 44% of all new HIV infections among adolescents, 13 years of age and older, and adults [Centers for Disease Control and Prevention [CDC], 2012). These statistics become even more dismal when both race and gender enter the …

Effectiveness Of Psychotherapy For Youth In Poverty: A Benchmarking Study Of A Public Behavioral Health Agency Using A Client Feedback System, Jonathan Kodet

Theses and Dissertations--Educational, School, and Counseling Psychology

Objective: The purpose of this study was to evaluate the effectiveness of a public behavioral health (PBH) agency that had implemented continuous outcome feedback as a quality improvement strategy.

Method: I investigated the pre-post treatment outcomes of 4,389 ethnically diverse youths (6 to 17 years old) at or under the poverty line participating in treatment (from January 2008 to March 2014) for a broad range of primary diagnoses including depression and anxiety disorders (23%); adjustment disorders (27%); Attention Deficit/Hyperactivity Disorder (13%), various V-codes (18%); bipolar disorders (3%); and substance use disorders (2%). I also investigated the treatment outcomes …

Reversible Downregulation Of Hypothalamic-Pituitary-Gonadal Axis In The Stallion With A Third-Generation Gnrh Antagonist, Gabriel Monteiro Davolli

Theses and Dissertations--Veterinary Science

The objectives of this thesis were: (1) to evaluate the downregulation of the stallion hypothalamic-pituitary-gonadal (HPG) axis by a GnRH antagonist (acyline) based upon endocrine, seminal, testicular and behavioral effects, and (2) to assess recovery after treatment. Stallions were treated for 50 days (n=4; 330µg/kg acyline q 5d) and controls (n=4) received vehicle alone. Stallions were assessed pre-treatment and for 72 days after last treatment. Treatment induced declines (p<0.05) in FSH, LH, testosterone (to castrate levels) and estrone sulfate. Gonadotropins and testosterone returned to control values within nine days and estrone sulfate by 14 days after treatment discontinuation. Acyline-treated stallions failed to respond with FSH, LH and testosterone increase after exogenous GnRH stimulation (25µg gonadorelin, IV) compared to pre-treatment and control stimulation. Total sperm numbers and motility were reduced in acyline-treated stallions, as well as total seminal plasma protein and testicular volume (p<0.05). Time to ejaculation was increased in acyline group (p<0.5). Testicular, sexual behavior and most seminal parameters regained normal levels within 72 days after treatment ceased. Sperm output of acyline-treated stallions was regained within seven months after ending treatment. Acyline reversibly suppressed the stallion HPG axis, thus has potential for treating the androgen-dependent Equine-Arteritis-Virus carrier state and as behavior modulator.

Do Air Pollutant Emissions Lead To An Increase In Total Personal Health Care Costs By State?, Dana Jespersen

MPA/MPP/MPFM Capstone Projects

Total personal health care costs are increasing in the United States every year. Currently personal health care costs are predicted to increase at a national average rate of 6.5 percent. This is on track with the historical data. The increase has returned to the 6.0 percent mark after falling down to an increase of 3.7 percent in 2013. Recovering from the recession and the implementation of the Affordable Care Act has contributed to the steady increase back up to the average 6 percent increase per year. When looking at individual states, all averaged around the 6 to 8 percent increase …

The Impact Of Prenatal Depressive Symptoms, Intimate Partner Relationship, And Immune Status On Postpartum Depression, Julia J. Hall

Theses and Dissertations--Nursing

The prevalence of depression during pregnancy in the U. S. is approximately 13%. Poor quality of the intimate partner relationship is significantly correlated with depression during pregnancy. The adverse effects of antenatal depression have been widely documented. The relationship between the intimate partner relationship and depression during pregnancy has not been well delineated in the literature. Little data exist regarding the impact of prenatal immune status on risk for postpartum depression. Due to limited evidence, there is a critical need to examine the relationship among trimester specific cytokines, quality of the intimate partner relationship, and antenatal depressive symptoms on risk …

Explore The Relationship Among Lung Cancer Stigma, Social Support, And Psychosocial Distress, Lisa Maggio

Theses and Dissertations--Nursing

There is longstanding causal relationship between cigarette smoking and lung cancer. Smoke-free policies and anti-smoking campaigns have been linked to the decline in smoking acceptance and contribute to the unintended consequence of stigmatizing smokers. Lung cancer is viewed as a self-inflicted disease and patients’ feel judged in a manner different from other cancers affecting social interactions between family, friends, and healthcare professionals. Lung cancer stigma contributes to depression, anxiety, poor self-esteem, guilt, shame, blame, threatens a person’s social identity, and limits social support that deeply affects patients and their support persons.

This dissertation contains a review of the literature related …

Muscular And Neural Contributions To Postactivation Potentiation, Brian Joseph Wallace

Theses and Dissertations--Kinesiology and Health Promotion

Muscle performance is partially a consequence of its recent contractile history. Postactivation potentiation (PAP) can occur after muscle contractions and leads to enhanced neuromuscular performance. The purpose of this dissertation was to explain the relationship between muscle factors (twitch potentiation, TP) and neural factors (reflex potentiation, RP) contributing to overall PAP following a non-fatiguing volitional muscle contraction. The tibial nerves of fifteen resistance trained volunteers (eleven men, four women) were stimulated intermittently at supramaximal (Mmax) and submaximal (Hmax) intensities for 20 minutes on separate days under three conditions: rest (Control); after a after a 10 second maximum voluntary isometric contraction …

Problem Solving Of Typically Developing Children On An Adaptation Of The Twenty Questions Task, Janice Carter Smith

Theses and Dissertations--Rehabilitation Sciences

This cross sectional study examined problem solving by typically developing children on the Rapid Assessment of Problem Solving test (RAPS). The RAPS, a modification of Mosher and Hornsby’s 20Q task, requires the examinee to solve three problems. Each problem involves asking yes/no questions to identify a target picture from a 32-picture array with as few questions as possible. Participants were 73 young (ages 7-9), 79 early adolescent (ages 10-13) and 77 adolescent (ages 14-17) children residing in Kentucky. Children were seen in the summer months and administered the RAPS on a single occasion, with 22 of the children being testing …

Salmonellosis In Kentucky Cattle - 2003-2014, Azia Elizabeth Ramirez

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

The group of bacteria known collectively as Salmonella has historically been a major cause of both health and economic hardships. In particular, Salmonella in bovine has been estimated to cause the economy to lose billions of dollars annually, both due to the increased morbidity and mortality rates of the cattle themselves and the indirect loss of potential profits, and also results in the spread of the bacteria to humans to ill effect. Salmonella thus can be quite taxing to agricultural communities, the animals upon which they rely, and the consumers that buy said communities’ commodities. Thus, the importance of an …

Development, Implementation, And Evaluation Of Refugee Health Literacy Program (R-Help), Cecilia A. Boateng

DNP Projects

Problem Statement: United States refugees often encounter significant barriers when adapting to their new host country; such as cultural and language barriers, and difficulty in navigating through the American healthcare system. For example, navigating through the American Pharmacy system to buy or refill medications is a great challenge for most refugees. To make matters worse, most refugees have difficulty understanding medications instructions which puts them at risk for making medication errors.

Purpose: The purpose of this study was to develop, implement, and evaluate the feasibility of delivering an evidence based health literacy medication educational program for all newly-arrived refugees attending …

2013 Jin Shin Jyutsu® Patient Response, Nathan Garrett

DNP Projects

Background: Pain and stress are symptoms experienced by many patients with cancer. Integrative therapies including energy therapies can help manage these symptoms. Jin Shin Jyutsu (JSJ) is one such energy therapy, but there is limited research regarding its utility on pain and stress for patients with cancer.

Objectives: The following study had two main objectives: 1) evaluate the self-reported perception of pain and stress before and after a first-time JSJ session, and 2) examine gender differences in perceptions of pain and stress following JSJ.

Methods: A retrospective study employing a pretest-posttest design was used to examine the perceptions of pain …

Stress In Parents Of Children With Type 1 Diabetes, Megan B. Carter

DNP Projects

Pediatric healthcare providers across the country care for many children with complex chronic diseases. Many of these children are not developmentally mature enough to manage their disease process, leaving the parent of the chronically ill child to manage their disease. The parent of the chronically ill child may experience stress related to their child’s illness, termed pediatric parenting stress, and may have difficulty dealing with this stress (Streisand, Kazak, & Tercyak, 2003). The manuscripts in this Practice Inquiry Project further investigate the relationship between pediatric parenting stress and the health of the parent and the chronically ill child. The instruments …

Evaluation Of An Educational Intervention To Improve Nurse Managers' Understanding Of And Self-Assessed Competence With Personnel Budgeting, Sue J. Mcfarlan

DNP Projects

Purpose: The purpose of this paper is to report on the process and outcomes of a DNP practice inquiry project.

Design: The design is a pretest posttest comparative evaluation.

Setting: The University of Kentucky Healthcare Chandler, Samaritan, and KY Children’s hospitals.

Subjects: A voluntary convenience sample of nurse managers was obtained (n=10)

Intervention: The intervention was a 2 hour didactic session and an individualized one-on-one educational session focused on general healthcare finance terms and more specifically on personnel budgeting and productivity metrics

Measures: The pretest and posttest consisted of 20 questions obtained from healthcare finance texts and preparatory materials for …

Adolescent Risk Behaviors, Screening, And Referral At An Adolescent Health Clinic: A Retrospective Review, Cheryl Marrs

DNP Projects

Aim: Investigate provider patterns of risk behavior screening at an adolescent health clinic and describe findings from a study that investigated patterns of risk behavior screening in an adolescent health clinic.

Background: Adolescents who engage in risky behaviors are vulnerable to problems with current and future mental health issues such as depression, substance use, or other psychiatric disorders. Identifying the risky behaviors in adolescents that are associated with the potential presence of depressive symptoms can be helpful to the provider when deciding to refer an adolescent for further mental health assessment. Provider fidelity in risk behavior screening is central to …