Medicine and Health Sciences Commons^™

Abl1/2 And Ddr1 Cooperate To Stabilize Braf/Craf To Drive Erk1/2 Reactivation And Promote Mek Inhibitor Resistance In Nras-Mutant Melanomas, Anastasia Lyon

Theses and Dissertations--Pharmacology and Nutritional Sciences

This study addresses the escalating incidence of NRAS-mutant melanomas, a type of skin cancer lacking FDA-approved targeted therapies. Despite ongoing research targeting the RAF/MEK/ERK pathway, existing drugs fail to enhance progression-free survival due to acquired resistance. This project identifies a novel role for ABL1/2 and DDR1 kinases in driving drug resistance and proliferation of NRAS-mutant melanoma cells. ABL1/2 and DDR1 cooperate to promote RAF homodimerization and protein stability in order to reactivate MEK/ERK signaling to drive MEK1/2 inhibitor (MEKi) resistance and promote survival of resistant cells. By targeting ABL1/2 and DDR1 with nilotinib, a FDA-approved anti-leukemic inhibitor, we …

The Function Of The Insulin Receptor In Liver Subcell Types And Its Dichotomous Role In Hepatic Dysfunction, Wang-Hsin Lee

Theses and Dissertations--Pharmacology and Nutritional Sciences

Insulin resistance and metabolic dysfunction-associated steatotic liver disease (MASLD) have become significant health issues worldwide. Increased prevalence of hepatic insulin resistance and MASLD worsens the threat of its progressive complications, such as liver fibrosis, which can lead to cirrhosis and death if left untreated. Treatments for MASLD-induced liver fibrosis are mainly insulin sensitizers. However, activating insulin signaling leads to a higher death rate in end-stage liver fibrosis. This dissertation discusses the emerging insights into hepatic insulin resistance and potential treatment targets in the heme degradation pathway for reversal. We also investigated the mechanisms that the insulin receptor (INSR) regulates in …

Exenatide As Chronopharmacotherapy For T2dm Associated Complications: Targeting Nondipping Blood Pressure And Sleep Insufficiency, Aaron Chacon

Theses and Dissertations--Pharmacology and Nutritional Sciences

Although largely impacted by age, race and ethnicity, and socioeconomic factors, Type 2 Diabetes Mellitus (T2DM) is primarily driven by obesity, currently affecting ~30 million in the U.S and ~463 million globally. T2DM carries numerous complications, including high prevalence of hypertension and nondipping blood pressure (BP), sleep insufficiency and fragmentation. Nondipping BP is an inadequate drop in BP (≤ 10%) during sleeping hours compared with waking hours. Lending to this, sleep disturbance acts as both precursor and consequence of metabolic dysregulation, greatly impacting circadian rhythmicity. To model these conditions, we utilized diabetic (db/db) mice. These mice carry a point mutation …

Cell-Based Cardiac Repair And The Natural Cardiac Healing In Regenerative Adult Mammal, Hsuan Peng

Theses and Dissertations--Pharmacology and Nutritional Sciences

Heart failure (HF) following myocardial infarction (MI) remains a significant global health concern, with the initial ischemic injury often leading to microvascular damage and infarct expansion, exacerbating the overall cardiac impairment. Despite extensive research, there are currently no effective therapies to limit myocardial damage post-MI, resulting in a substantial number of patients progressing to HF. Stem cell therapy has emerged as a promising approach to modulate cardiac injury and promote healing. However, clinical trials have shown only modest success, underscoring the need for improved strategies to enhance efficacy. Additionally, the lack of significant ventricular regeneration highlights the necessity of targeting …

The Delineation Of Platelet Pathology In Cardiometabolic Disease, Chi Peng

Theses and Dissertations--Pharmacology and Nutritional Sciences

Obesity is a multifactorial disease with many comorbidities leading to multiorgan dysfunction. Current studies point towards dysregulation of platelet signaling as a driver for increased risk of cardiovascular disease and stroke. The exact mechanisms remain elusive due to the complex interplay of factors involved, warranting the need to further understand how platelets are affected. Our preliminary data evaluating changes in platelet and coagulation parameters from bariatric patients showed that obesity did not affect platelet count or clotting time as demonstrated in INR values. However, female patients had increased bleeding events before surgery that were decreased after surgery. Due to limitations …

Characterization Of Bowel Dysfunction After Spinal Cord Injury In Mice, Olivia Wireman

Theses and Dissertations--Physiology

Most individuals who suffer a spinal cord injury (SCI) will experience some form of bowel dysfunction. Trauma to the spinal cord can result in severe constipation and/or incontinence, otherwise known as neurogenic bowel. Constipation requires extensive bowel routines typically involving the help of another person. Still, many living with SCI are hospitalized due to bowel complications such as fecal impaction. While neurogenic bowel has been well characterized in the clinic, pre-clinical models of neurogenic bowel after SCI are still in development. Most pre-clinical studies in bowel dysfunction after SCI are published in rat models. Studies existing in mice, to our …

Maternal-Adolescent Communication About Sex And Risky Sexual Behaviors: A Cross-Cultural Comparison Of Czech, Spanish, And Taiwanese Youth, Mckinley Hall

Theses and Dissertations--Family Sciences

This present study aimed to test the relationship between perceived maternal-adolescent communication about sex and risky sexual behaviors, while also considering the links between perceived maternal-adolescent closeness and maternal-adolescent conflict with risky sexual behaviors, across three culturally distinct countries, namely the Czech Republic (N=878, mean age of 17.93), Spain (N =1024, mean age of 18.79), and Taiwan (N =1443, mean age of 16.48). Samples of adolescents from each country were used and statistical analyses were conducted to test the hypothesized relationships. Based on path analysis carried out on each sample, the results revealed that Czech adolescents reported the highest levels …

Nutrient Profile Assessment Of A Meal Program Impact On Older Adults' Diet Quality And Food Security Status, Millicent Yaa Gyasiwaa Ms

Theses and Dissertations--Nutrition and Food Systems

The rise in food insecurity globally has ignited institutions and organizations to implement policies and programs to reduce the burden on vulnerable people including older adults and people living in underserved areas. Though programs such as congregate, home-delivered meals, and pantries have been initiated to contribute to reducing food insecurity the nutrient content of these meals including recovered meals and their effect on food security status, food quality, and health has not been widely studied. The current study, Meals on Wings (MOW), assessed the nutrient profile of the free meals offered 4 times per week for 3 months, from May …

Acting On Routine Outcome Monitoring, Virginia Courtney

Theses and Dissertations--Family Sciences

This thesis explores the application of an Acceptance and Commitment Therapy (ACT) informed approach in achieving clients’ therapeutic objectives via systematically tracking client progress over the therapy process. The study utilized the Marriage and Family Therapy Practice Research Network (MFT-PRN), a specific tool that aids the tracking of therapy progress, to gather relevant client data. The data consisted of therapy progress for 27 individuals the author worked with, 1,001 individuals from the Individual Relational and Finance Therapy Clinic, and 4,424 individuals from the MFT-PRN-Network. Upon collecting this data, progress trajectories were generated using Microsoft Excel to compare the author’s clients’ …

Division Of Labor And Relationship Satisfaction: Examining The Mediating Role Of Self Esteem, Ellen Keith

Theses and Dissertations--Family Sciences

As a result of feminist movements, rejections of gender roles, and changing economic conditions, profound changes have occurred within the structure of American families. This study delves into the intricate dynamics of divisions of household labor (DoL), self-esteem, and relationship satisfaction within the context of contemporary relationships. Drawing on data from the Panel Analysis of Intimate Relationships and Family Dynamics (Pairfam), this study tested five hypotheses, and investigates how perceptions of fairness in DoL tasks influence self-esteem and relationship satisfaction. Significant associations were found between reported share of DoL and indicated fairness of DoL, indicated fairness of DoL and relationship …

Sex Differences In Pediatric Hypertension: Obesity, Stress, And The Renin-Angiotensin System, Allyson Dyar

Theses and Dissertations--Nutrition and Food Systems

Pediatric hypertension, linked to long-term cardiovascular risks, shows increasing prevalence and varying patterns between boys and girls. This study explores sex-based differences in hypertension among 251 children aged 6-18 from Kentucky Children’s Hospital. Using 24-hour ambulatory blood pressure monitoring (ABPM) and assessing plasma renin, aldosterone, and cortisol, we examined blood pressure severity by sex. Girls showed a higher incidence of severe hypertension and elevated cortisol levels, whereas boys had higher mean systolic blood pressure. Aldosterone was associated with night systolic blood pressure in girls, while night diastolic blood pressure was linked to aldosterone in both sexes and renin in girls. …

Examining Anxious Attachment And Its Effects On Sexual Behaviors In Adulthood, Justin Graham

Theses and Dissertations--Family Sciences

The current study aimed to investigate the relationship between anxious attachment and adult sexual behaviors. The study utilized pairfam, a nationally representative German sample, as a secondary data set for its quantitative analysis. Participants responded to two anxious attachment scales and questions regarding sexual desire, sexual confidence, and age at first sexual experiences. Analyzing data from 5561 individuals, averaging 29.27 years old, a path analysis was conducted to assess variable effects. Findings indicate that higher anxious attachment correlates with reduced sexual confidence and earlier onset of sexual intercourse. Future studies should investigate additional attachment scales and include a more diverse …

Examining The Feasibility Of Implementing Farm To School Programs In Rural Kentucky Schools: Barriers And Successes Of Initiating Programming As Identified Through Teacher’S Observations, Christina Wilson

Theses and Dissertations--Nutrition and Food Systems

Farm to School (FTS) programs provide experiential learning opportunities to children that have the potential to shape eating patterns and, in turn, improve health and learning outcomes. Participation in FTS programs in Kentucky is growing. However, programming varies widely across schools, and few have an edible school garden. This study examined the feasibility of establishing an edible school garden while incorporating FTS programming by evaluating teachers' observations and experiences. Six rural Kentucky schools were selected to receive a $5,000 grant to initiate an edible school garden and incorporate FTS programming. A Qualtrics survey measured six categories regarding implementation. The results …

Role Of Social Determinants Of Health And The Renin- Angiotensin Aldosterone System In Risk For Hypertensive Disorders Of Pregnancy And Related Adverse Outcomes., Esther Letushila Ndashaala

Theses and Dissertations--Nutrition and Food Systems

Background: Hypertensive disorders of pregnancy (HDP) represent a significant public health issue, contributing to maternal and fetal morbidity and mortality. Women from lower socioeconomic backgrounds or marginalized racial and ethnic groups face higher risks of HDP, which have been incompletely described. In addition, risk for HDP may be linked to a reduction in the normal activity of the renin-angiotensin-aldosterone system (RAAS). This study investigates the role of socioeconomic factors and RAAS components in the risk for HDP and adverse maternal and neonatal outcomes. Methods: This study is a secondary analysis of data from 180 pregnant individuals from a high-risk maternal-fetal …

Influencers Of Fidelity In Implementation Of Go Napsacc At Selected Early Childhood Education Centers In Kentucky, Adeyimika Desmennu

Theses and Dissertations--Nutrition and Food Systems

Several lifestyle interventions have been explored to ameliorate obesity and most associated non-communicable diseases in children attending early childhood education settings (ECE). Go Nutrition and Physical Activity Self-Assessment for Child Care (NAPSACC) program has been implemented nationally to improve dietary intake and physical activities among children in ECE settings. However, a large proportion of ECE centers do not complete the five-step process that leads to change. This project, thus, aims to identify contextual factors that facilitate and/or impede the fidelity in implementation of Go NAPSACC.

This thesis is a comparative case study using secondary data to compare, and contrast reported …

Current And New Perspectives On Equine Protozoal Myeloencephalitis Therapeutics, Izabela De Assis Rocha

Theses and Dissertations--Veterinary Science

Equine protozoal myeloencephalitis (EPM) is an important neurologic disease of horses in the Americas. It is caused by the apicomplexan parasite Sarcocystis neurona and less commonly by the related parasite Neospora hughesi. Current antiprotozoal treatment relies on the use of either folate inhibitors (sulfadiazine/pyrimethamine) or triazine drugs (diclazuril/ponazuril), with a success rate of 60-70% regardless of the drug of choice. Successful treatment is defined as the improvement of at least one ataxia grade following the modified Mayhew scale, which often is not enough for the horse to return to the previous level of performance. The goals of this dissertation …

Evaluating The Caring Cards Program And Its Effect On Mental Health Indicators Among A Self-Defined Agricultural Group In Rural Kentucky, Katrina Clontz

Theses and Dissertations--Community & Leadership Development

Suicide is currently the 11^th leading cause of death in the Unites States (American Foundation for Suicide Prevention, 2024), and is especially high among the farming and agricultural population (Kennedy et al., 2021; Klingelschmidt et al., 2022; Monteith et al., 2020). Additionally, mental health access and outcomes are worse among this population, partially due to the inaccessibility of care in rural areas (Taylor, 2019). Communication among caring individuals is thought to be an effective suicide prevention strategy (Long, 2023; Ross & Bassilos, 2019). The Caring Cards program was developed as a way to facilitate mental health communications among a …

Development Of Functional Plasmonic Nanoceria For The Ultrasensitive Detection Of Ebola Glycoprotein, Carissa A. Sutton

Graduate Theses/Dissertations

Infectious diseases have been increasing in both severity and prevalence, leading to increasing economic burdens and health concerns. Ebola hemorrhagic fever is an infectious disease that is both highly communicable and highly fatal. Current detection methods for the virus have high specificity and sensitivity but have long and/or complicated procedures that do not allow for early virus detection in highly affected areas. Compared to the lengthy procedure of reverse transcription-polymerase chain reaction (RT-PCR), real-time RT-PCR is more time-efficient; however, specificity and sensitivity are reduced. Since early detection of the virus is the only way to increase survival rates, sensitive detection …

Sensory Home Programming Handouts, Taylor Ann Koopmeiners

Occupational Therapy Capstones

Background: Sensory processing is the way the brain and nervous system receive sensory information (Star Institute, 2023). When there are difficulties with processing sensory information, it is called Sensory Processing Disorder (SPD). Consequently, the inability to process sensory input results in affected motor and behavioral responses (Star Institute, 2023. This creates difficulty in participating in necessary tasks such as activities of daily living (ADLs), social participation, and school (Lane et al., 2019; Star Institute, 2023). Occupational therapists address these challenges by providing sensory activities in therapeutic sessions and as part of home programming (Gabriele, 2020). The goal of this scholarly …

An Occupational Therapy Approach To The Cumulative Trauma Disorder Of Trigger Finger: A Case Report, Makenzie Lynn Kroupa

Occupational Therapy Capstones

Background: The purpose of this product is to focus on furthering exposure to cumulative trauma disorder (CTD) of the upper extremity (UE) through the development of a case report. This will further explore treatment methods, therapy progression, and management for diagnoses that are associated with repetition and the overuse of the UE. The client of focus possesses the UE CTD of trigger finger as the primary diagnosis but has several concurrent conditions. This increases the complexity of the case since the client must navigate the symptomatology of UE CTDs to engage in occupational performance.

Case Presentation: The client was selected …

The Distinct Role: A Toolkit To Promote Occupational Therapy Services For Palliative Care Patients In Acute Care Hospitals, Kailey Ann Squier

Occupational Therapy Capstones

Purpose: Each year, 56.8 million people receive palliative care services and experience significant impacts overall quality of life. Occupational therapy is well-equipped to maximize engagement in meaningful activities and improve overall quality of life for this population. Despite evidence supporting the unique value of OT, it has had many barriers limiting the ability to expand into palliative care effectively. There is a need to provide education and increase resources to occupational therapy practitioners (OTPs) in palliative care. The purpose of this scholarly project was to increase the understanding of OTs’ role in palliative care and promote increased OT services within …

Breaking The Barrier To Leisure Engagement In Long-Term Care Facilities To Enhance Residents’ Health, Well-Being, And Quality Of Life, Callie M. Kleindl

Occupational Therapy Capstones

Title: Breaking the Barrier to Leisure Engagement in Long-Term Care Facilities to Enhance Residents’ Health, Well-being, and Quality of Life

Purpose: The purpose of this scholarly project was to promote leisure engagement for residents with dementia in long-term care (LTC) facilities to enhance their overall health, well-being, and quality of life (QOL).

Methodology: A thorough literature review supported the need for increased leisure engagement in LTC facilities for residents with dementia. Chronic conditions, such as dementia, impact a resident’s ability to engage in meaningful occupations which leads to occupational deprivation. In addition, a decline in leisure engagement has been found …

An Intergenerational Program Approach To Support Successful Aging And Decrease Social Isolation In Nursing Home Residents, Mariah Herring

Occupational Therapy Capstones

Purpose As older adults transition to nursing facilities, their involvement in community activities diminishes, impacting their physical health, cognitive abilities, and social engagement (Lowry et al., 2012; Serrat-Graboleda et al., 2010). Evidence suggests that utilizing intergenerational programs in nursing facilities can effectively reduce social isolation, enhance quality of life for residents, and support academics and social skills in preschool students (Gustavsson, 2015; Lowry et al., 2012; Mondaca et al., 2018; Pillemer et al., 2022; Tak et al., 2015). This scholarly project aims to support successful aging and decrease social isolation in nursing facilities through the development of occupation-based psychomotor activities …

Primary Reflex Testing And Integration Guide For Parents And Providers, Abby Jessen

Occupational Therapy Capstones

Purpose: Parents are often unaware of the signs and characteristics of retained reflexes making it difficult to identify if there is a problem (Grigg et al., 2018). Once a problem is identified parents are frequently uninformed of the effects primary reflexes can have on a child’s development and how to foster integration (Grigg et al., 2018). Therefore, demonstrating a need for parent and provider education to support reflex integration amongst the pediatric population. The purpose of this project was to educate parents and providers on retained primary reflexes in children ages four to 11.

Methods: Prior to the start of …

Sensory Toolkit For Childcare Providers And Parents Of Children In The Daycare Setting, Cierra Marie Jacobson

Occupational Therapy Capstones

Title: Sensory Toolkit for Childcare Providers and Parents of Children in the Daycare Setting

Purpose: Around 62% of children in the United States receive care from care-based centers (U.S Department of Education, National Center for Education Statistic [NCES], (2021). Of the children in daycare, about 41% attend for 35 or more hours a week (Capizzano & Adams, 2000). The children’s environment within a daycare provides several sensory experiences that can both support and hinder their success in their daily occupations. When sensory needs are unmet, undesired behaviors can occur and impact their performance in daily occupations (Bodison & Parham, 2017). …

A Resource Guide For Improving Participation In The Pediatric Casper Community, Rylie Garner

Occupational Therapy Capstones

Title: A Resource Guide for Improving Participation in the Pediatric Casper

Community Background and Problem: Regardless of ability level, all children should have the same rights, access, and opportunities to participate in leisure, social, physical, and recreational activities. Research shows that typically developing children participate more in social, physical, and recreational activities than children with disabilities (Solish et al., 2010). Identified barriers that can decrease participation for children with disabilities include the child’s functional limitations, high costs, accessibility, and lack of known nearby facilities, programs, and sports (Murphy & Carbone, 2018; Aytur et al., 2018). Participation in leisure, social, physical, …

Addressing Occupational Deprivation And Alienation In Rural Skilled Nursing Facilities Through An Activities Resource Guide, Stephanie Dullum

Occupational Therapy Capstones

Purpose: The purpose of this product was to collaborate with residents and the activities department in a rural skilled nursing facility (SNF) to create leisure activities to address common chronic conditions and the needs or wants of the residents. With aging comes more chronic conditions and less physical activity, socialization, and time engaged in activities, affecting quality of life (QOL) and well-being (Causey-Upton,2015; Cudjoe et al., 2020; Nedjeljeko et al., 2021; Portillo et al., 2023; Sen et al., 2022; Smallfield & Molitor, 2018; World Health Organization [WHO], 2022). Providing residents with more meaningful leisure activities will assist the SNF staff …

Peer To Peer: Implementing An Inclusive Program At A Midwestern School, Kaitlyn Rose Ekre

Occupational Therapy Capstones

Purpose: Transitioning to and between school settings (i.e., home to elementary, elementary to middle school, middle school to high school) can be a challenging experience for everyone. In middle school, there is an increase in academic, behavioral, and social demands (Chen et al., 2020; Fontil et al., 2020). While most students are able to navigate the different demands of middle school, students with disabilities struggle with building relationships and interacting with their peers along with academics leading to low involvement in extracurricular activities, inconsistent access to the general education classroom, and an absence of peer interactions throughout the day (Biggs …

Making Strides: An Occupational Therapy Program Developing Work Readiness Skills In Adolescents With Aces, Using Equine And Barn Tasks., Lauren Alexis Fischer

Occupational Therapy Capstones

Background: The Center of Disease Control and Prevention (CDC, 2022) defines adverse childhood experiences (ACEs) as any traumatic event that occurs from birth to 18 years. ACEs can lead to various issues in the child's future, such as health problems, mental illness, substance abuse, and challenges with education and employment (CDC, 2022). Associated barriers that inhibit at-risk youth when transitioning into the workforce include lack of work skills, habits, knowledge about labor rights, realistic job opportunities, and how to pursue employment (Ivzori et al., 2020). Increasing support in their pre-vocational skills can increase their success in employment. Rhew et al. …

An Occupation-Based Approach To Stroke Recovery In Rural America, Julia Warmack

Occupational Therapy Capstones

Purpose In the United States, strokes are one of the leading causes of death as well as a leading cause of long-term disability (Centers for Disease Control and Prevention [CDC], 2022). Due to the disease's demanding and intense nature, occupational therapists must provide evidence-based care to help support those in need. Occupation-based treatment has been proven to provide better long-term results and improve the transferability of skills (Rostami et al., 2017). However, many practitioners still rely on rote exercise due to lacking resources, access, or training (Centers for Disease Control and Prevention [CDC], 2017).

Methodology A model-guided literature review was …